Abdominal manifestations of sickle cell disease (SCD) are wide and can involve many organs.
For a general discussion, please refer to sickle cell disease.
Splenic
-
splenomegaly
- may occur transiently with the sequestration syndrome, where rapid pooling of blood occurs in the spleen, resulting in intravascular volume depletion, with potential for cardiovascular collapse
-
autosplenectomy
- the slow, tortuous micro-circulation of the spleen renders it susceptible to infarction and subsequent functional asplenia
- 94% are asplenic by age 5 1
- radiological finding is of a small, calcified spleen
- splenic abscesses
Hepatobiliary
- hepatic iron deposition secondary to multiple transfusions 1
- hepatomegaly +/- coarsened echotexture with portal hypertension
- cholelithiasis +/- choledocholithiasis
- multiple liver abscesses
Renal
- kidneys are often large early in the disease, with variable echogenicity on ultrasound, but shrink with development of renal failure. Bilateral echogenic pyramids are frequently seen in sickle cell disease
- renal papillary necrosis
- renal vein thrombosis
Gastrointestinal tract
- approximately 40% of patients may develop peptic ulcers due to reduced mucosal resistance and bowel ischemia
- girdle syndrome: acute circumferential abdominal pain of vaso-occlusive etiology 5