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Abdominal Pain in Children With Sickle Cell Disease

Rhodes, Melissa M. MD*,†; Bates, David Gregory MD*,†; Andrews, Tina RN, BSN*; Adkins, Laura RN, BSN*; Thornton, Jennifer APN*,†; Denham, Jolanda M. MD*,†

Journal of Clinical Gastroenterology:
doi: 10.1097/01.mcg.0000436436.83015.5e
Clinical Reviews
Abstract

The differential diagnosis of abdominal pain is broad in any child, and further complicated in children with sickle cell disease (SCD). Acute causes of abdominal pain may require emergent surgery, such as for appendicitis or obstruction caused by a bezoar. Rapid intervention is necessary and life-saving in children with SCD and acute splenic or hepatic sequestration. The majority of children with SCD presenting to the physician’s office or emergency department will have subacute reasons for their abdominal pain, including but not limited to constipation, urinary tract infection, peptic ulcer disease, and cholecystitis. Vaso-occlusive pain often presents in children as abdominal pain, but is a diagnosis of exclusion. The case of a 10-year-old girl with intermittent abdominal pain is used as a starting point to review the pathophysiology, diagnosis, and treatment of the most acute and common causes of abdominal pain in children with SCD.

Author Information

*Nationwide Children’s Hospital

Department of Pediatrics, The Ohio State University, Columbus, OH

The authors declare that they have nothing to disclose.

Reprints: Melissa M. Rhodes, MD, Hematology/Oncology/BMT, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43235 (e-mail: melissa.rhodes@nationwidechildrens.org).

© 2014 by Lippincott Williams & Wilkins