Ahmed Shahid, Siddiqui Anita K, Siddiqui Rina K, Kimpo Miriam, Russo Linda, Mattana Joseph
Department of Medicine, Long Island Jewish Medical Center, The Long Island Campus for the Albert Einstein College of Medicine, New Hyde Park, New York 11040, USA.
Am J Hematol. 2003 Jul;73(3):190-3. doi: 10.1002/ajh.10344.
Sickle cell disease is characterized by chronic hemolytic anemia and vaso-occlusive painful crisis. The vascular occlusion in sickle cell disease is a complex process and accounts for the majority of the clinical manifestations of the disease. Abdominal pain is an important component of vaso-occlusive painful crisis and may mimic diseases such as acute appendicitis and cholecystitis. Acute pancreatitis is rarely included as a cause of abdominal pain in patients with sickle cell disease. When it occurs it may result form biliary obstruction, but in other instances it might be a consequence of microvessel occlusion causing ischemia. In this series we describe four cases of acute pancreatitis in patients with sickle cell disease apparently due to microvascular occlusion and ischemic injury to the pancreas. All patients responded to conservative management. Acute pancreatitis should be considered in the differential diagnosis of abdominal pain in patients with sickle cell disease.
镰状细胞病的特征为慢性溶血性贫血和血管阻塞性疼痛危象。镰状细胞病中的血管阻塞是一个复杂的过程，并且是该疾病大多数临床表现的原因。腹痛是血管阻塞性疼痛危象的一个重要组成部分，可能会与急性阑尾炎和胆囊炎等疾病相混淆。急性胰腺炎很少被列为镰状细胞病患者腹痛的病因。当它发生时，可能是由于胆道梗阻所致，但在其他情况下，它可能是微血管阻塞导致局部缺血的结果。在本系列中，我们描述了4例镰状细胞病患者发生急性胰腺炎的病例，显然是由于胰腺微血管阻塞和缺血性损伤所致。所有患者对保守治疗均有反应。在镰状细胞病患者腹痛的鉴别诊断中应考虑急性胰腺炎。
