Jebbin N J, Adotey J M
Department of Surgery, University of Port Harcourt Teaching Hospital, P M B 6173, Port Harcourt, Nigeria.
Ann Afr Med. 2011 Apr-Jun;10(2):165-70. doi: 10.4103/1596-3519.82072.
Abdominal crises (vaso-occlusive) are not infrequent in patients with sickle cell anemia. They usually present as acute abdomen. These patients none the less present with other causes of acute abdomen like others without hemoglobinopathy. Six cases of surgical acute abdomen in sickle cell disease patients treated in the University of Port Harcourt Teaching Hospital (UPTH) are presented.
Six sickle cell anaemia patients presenting with acute abdominal conditions from 1999 to 2008 (inclusive) in the University of Port Harcourt Teaching Hospital were studied retrospectively (two patients) and prospectively (four patients). After initial resuscitation, appropriate surgical procedures, namely, appendicectomy (2), cholecystectomy (1), open drainage of splenic abscess (1), and release of adhesive band (1) were performed.
Six cases were treated (female/male ratio 2:1). Four patients were in the 11-20 year age group. Two patients had appendicectomy and two presented with acute cholecystitis/cholelithiasis, one of whom had open cholecystectomy. One young girl had drainage of splenic abscess and a 42-year-old male had division of obstructive adhesive band at laparotomy. There were two complications, namely, postoperative haemorrhage (in cholecystectomy patient) and acute chest syndrome (in one appendicectomy patient). These were successfully managed with blood transfusion and antibiotic/oxygen therapy, respectively. There was no mortality.
Sickle cell anaemia patients are not exempt from acute abdominal conditions requiring surgery. A high index of suspicion coupled with repeated clinical examination is needed for early diagnosis and appropriate treatment.
腹部危象（血管阻塞性）在镰状细胞贫血患者中并不罕见。它们通常表现为急腹症。然而，这些患者也会像其他无血红蛋白病的患者一样，因其他原因出现急腹症。本文介绍了在哈科特港大学教学医院（UPTH）接受治疗的6例镰状细胞病患者的外科急腹症病例。
回顾性研究（2例患者）和前瞻性研究（4例患者）了1999年至2008年（含）在哈科特港大学教学医院出现急性腹部疾病的6例镰状细胞贫血患者。在初步复苏后，实施了适当的外科手术，即阑尾切除术（2例）、胆囊切除术（1例）、脾脓肿切开引流术（1例）和粘连带松解术（1例）。
共治疗6例患者（女性/男性比例为2:1）。4例患者年龄在11至20岁之间。2例行阑尾切除术，2例表现为急性胆囊炎/胆石症，其中1例行开腹胆囊切除术。1名年轻女孩行脾脓肿引流术，1名42岁男性在剖腹手术时行梗阻性粘连带分离术。出现了2种并发症，即术后出血（胆囊切除术患者）和急性胸综合征（1例阑尾切除术患者）。分别通过输血和抗生素/氧气治疗成功处理了这些并发症。无死亡病例。
镰状细胞贫血患者也会出现需要手术治疗的急腹症。早期诊断和适当治疗需要高度的怀疑指数以及反复的临床检查。
