Approach to Abdominal Pain in Sickle Cell Anaemic Patients

Sickle cell disease is the term that involve both homozygous sickle cell anemia and the heterozygous sickle cell thalassemia disease. (1)
As a result of a single amino acid substitution (valine for glutamic acid at the β6 position), sickle hemoglobin crystallizes and forms a gel in the deoxygenated state. When reoxygenated, the sickle hemoglobin is normally soluble. The so-called reversible sickle cell can enter the microcirculation. As the oxygen is extracted and saturation declines, sickling may occur, occluding the microvasculature. The surrounding tissue undergoes infarction, inducing pain and chronic organ dysfunction. This sickling phenomenon is exacerbated by hypoxia, acidosis, fever, hypothermia, and dehydration. (2)
Musculoskeletal, chest, and abdominal pain are remarkable manifestations of the sickling.
Sickle cell patient with abdominal pain is one of the common presentations of the disease and one of its clinical dilemmas that impose itself to be discussed and clarified.