One of the less common sickle cell vaso-occlusive (vasocclusive) crisis is an ischemic colitis. The pattern of abdominal pain gives this the name "girdle syndrome."
In a young child this may be the first indication that the patient has sickle cell disease.
Clinical features:
(1) abdominal pain, which may be minimal or atypical
Laboratory findings:
(1) metabolic acidosis
The ischemia is potentially reversible with conservative management, but some patients progress to ischemic necrosis.
Narcotic analgesia may mask pain progression and delay surgery.
Complications:
(1) bowel perforation with peritonitis
Differential diagnosis:
(1) appendicitis
(2) cholecystitis
(3) splenic sequestration
(4) hepatic infarction
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