Massive splenic infarction in Saudi patients with sickle cell anemia: A unique manifestation

被引:22
作者
Al Jama, AH [1 ]
Al Salem, AH
Al Dabbous, IA
机构
[1] Qatif Cent Hosp, Dept Internal Med, Qatifi, Saudi Arabia
[2] Qatif Cent Hosp, Dept Internal Med, Qatif, Saudi Arabia
[3] Qatif Cent Hosp, Dept Surg, Qatif, Saudi Arabia
[4] Qatif Cent Hosp, Dept Pediat, Qatif, Saudi Arabia
关键词
sickle cell anemia; splenic infarction;
D O I
10.1002/ajh.10049
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Splenic infarcts are common in patients with sickle cell anemia (SCA), but these are usually small and repetitive, leading ultimately to autosplenectomy. Massive splenic infarcts on the other hand are extremely rare. This is a report of our experience with 8 (4 males and 4 females) cases of massive splenic infarction in patients with SCA. Their ages ranged from 16 to 36 years (mean 22 years). Three presented with left upper quadrant abdominal pain and massive splenic infarction on admission, While the other 5 developed massive splenic infarction while in hospital. In 5 the precipitating factors were high altitude, postoperative, postpartum, salmonella septicemia, and strenuous exercise in one each, while the remaining 3 had severe generalized vasoocclusive crises. Although both ultrasound and CT scan of the abdomen were of diagnostic value, we found CT scan more accurate in delineating the size of infarction. All our patients were managed conservatively with IN. fluids, analgesia, and blood transfusion when necessary. Diagnostic aspiration under ultrasound guidance was necessary in two patients to differentiate between massive splenic infarction: and splenic abscess: Two patients required splenectomy during the same admission because of suspicion of secondary infection and abscess formation, while a third patient had splenectomy 2 months after the attack because of persistent left upper quadrant abdominal pain. In all the 3 histology of the spleen showed congestive splenomegaly with massive infarction. All of our patients survived. Two patients subsequently developed autosplenectomy while the remaining 3 continue to have persistent but asymptomatic splenomegaly. Massive splenic infarction is a rare and unique complication of SCA in the Eastern Province of Saudi Arabia, and for early diagnosis and treatment, physicians caring for these patients should be aware of such a complication. (C) 2002 Wiley-Liss, Inc.
引用
收藏
页码:205 / 209
页数:5
相关论文
共 14 条
[1]   Sonographic assessment of spleen size in Saudi patients with sickle cell disease [J].
Al-Salem, AH ;
Al-Aithan, S ;
Bhamidipati, P ;
Al Jam'a, A ;
Al Dabbous, I .
ANNALS OF SAUDI MEDICINE, 1998, 18 (03) :217-220
[2]  
AlJama AH, 2000, AM J HEMATOL, V63, P68, DOI 10.1002/(SICI)1096-8652(200002)63:2<68::AID-AJH2>3.0.CO
[3]  
2-N
[4]  
ALSALEM AH, 1996, AM J SURG, V171, P254
[5]  
Bodo Imre, 1997, Blood, V90, p23B
[6]   SPLENIC INFARCTION IN A PATIENT WITH SICKLE-CELL-HEMOGLOBIN-C DISEASE - REPORT OF A CASE OCCURRING FOLLOWING AIR TRAVEL [J].
COLEMAN, WA ;
FURTH, FW .
ARCHIVES OF INTERNAL MEDICINE, 1956, 98 (02) :247-249
[7]  
GREAN RL, 1971, BRIT MED J, V4, P593
[8]  
LIPSHUTZ M, 1977, JAMA-J AM MED ASSOC, V8, P792
[9]   2 DIFFERENT FORMS OF HOMOZYGOUS SICKLE-CELL DISEASE OCCUR IN SAUDI-ARABIA [J].
PADMOS, MA ;
ROBERTS, GT ;
SACKEY, K ;
KULOZIK, A ;
BAIL, S ;
MORRIS, JS ;
SERJEANT, BE ;
SERJEANT, GR .
BRITISH JOURNAL OF HAEMATOLOGY, 1991, 79 (01) :93-98
[10]  
Powars D R, 1979, Am J Pediatr Hematol Oncol, V1, P343