Acute Appendicitis and Sickle Cell Anemia

Department of Surgery, Dar A lAlafia Medical Company, Qatif, Saudi Arabia


12.1 Introduction

  • Patients with sickle cell anemia (SCA), often present with abdominal pain, which is usually attributable to SCA abdominal vaso-occlusive crisis, and based on this, conservative therapy is advocated in the majority of patients with SCA who present with acute abdominal pain.

  • This however does not exclude the possibility of other common surgical conditions, namely, cholelithiasis, acute cholecystitis, peptic ulcer disease, and acute appendicitis which may be difficult to differentiate clinically from simple abdominal vaso-occlusive crisis.

  • Acute appendicitis remains the most common cause of acute abdomen requiring emergency abdominal operation. This however may not be the case in patients with SCA, where acute appendicitis is reported not only to be rare but also has a rapid course with a high incidence of perforation (Fig. 12.1).


    Fig. 12.1
    Abdominal CT scan showing acute perforated appendicitis with abscess formation

  • Acute appendicitis in patients with SCA has been reported not only to be rare but also different.

  • The reason for this low incidence of acute appendicitis in patients with SCA is not exactly known.

  • Based on this and the risks associated with surgery and anesthesia, it is advocated to limit surgical exploration to those with clear evidence of potential surgical pathology or progressive findings during a period of observation.

12.2 Pathology

Jun 6, 2017 | Posted by in ONCOLOGY | Comments Off on Acute Appendicitis and Sickle Cell Anemia
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