Stewart Camille L, Ménard Geraldine E
Section of General Internal Medicine, Tulane University School of Medicine, 1430 Tulane Ave, SL-16, New Orleans, LA 70112, USA.
J Natl Med Assoc. 2009 Jul;101(7):726-8.
Sickle cell-induced ischemic colitis is a rare yet potentially fatal complication of sickle cell anemia. Frequent pain crises with heavy analgesia may obscure and prolong this important diagnosis. Our patient was a 29-year-old female with sickle cell disease who was admitted with left lower quadrant abdominal pain. A diagnostic workup, including chemistries, complete blood count, blood cultures, chest x-ray, computerized tomography scanning, and colonoscopy, was performed to identify the etiology of her symptoms. This case highlights the importance of differentiating simple pain crisis from more serious and life-threatening ischemic bowel. A review of the literature compares this case to others reported and gives a method for diagnosing and treating this complication of sickle cell disease.
镰状细胞性缺血性结肠炎是镰状细胞贫血一种罕见但可能致命的并发症。频繁的重度镇痛疼痛危象可能会掩盖并延长这一重要诊断。我们的患者是一名29岁患有镰状细胞病的女性,因左下腹疼痛入院。进行了包括化学检查、全血细胞计数、血培养、胸部X光、计算机断层扫描和结肠镜检查在内的诊断性检查,以确定其症状的病因。本病例强调了区分单纯疼痛危象与更严重且危及生命的缺血性肠病的重要性。文献综述将本病例与其他报道的病例进行了比较,并给出了诊断和治疗镰状细胞病这一并发症的方法。