The Import of Abdominal Pain in Adults with Sickle Cell Disorder
BACKGROUND: The aetiology, clinical correlates and outcome of abdominal pain in Nigerian adults with sickle cell disorder (SCD) have not been extensively reported.
OBJECTIVE: To determine the prevalence of abdominal vasoocclusive
crisis in sickle cell patients with abdominal pain and their clinical correlates if any.
METHODS: Clinical records of adults with SCD (Hb SS and Hb SC) attending the Haematology Outpatients’ Clinic of the Obafemi Awolowo University Teaching Hospitals Complex, Southwest Nigerian, over a ten-year period, were reviewed. Demographic, clinical and laboratory data with respect to
abdominal pain were retrieved. Data were analysed using appropriate descriptive and inferential statistics.
RESULTS: A total of 154 records (128 Hb SS and 26 Hb SC) were available for assessment. The patients mean ages were 22.5 ± 7.3 years (Hb SS patients) and 24.2 ± 9.7 years (Hb SC patients) (p > 0.05). The prevalence of abdominal pain was 39.1% and 30.8% in Hb SS and Hb SC respectively (p > 0.05). Pain was commonly in the epigastrium; dull in 35% Hb SS, but peppery/burning in 37.5% Hb SC. All patients with
abdominal vaso-occlusive crisis (VOC) had diffuse/generalised dull abdominal pains. A diagnosis of gastritis/peptic ulcer disease was made in 50% of Hb SC patients and 28% of Hb SS patients. Abdominal VOC was diagnosed in 26% Hb SS, but none in Hb SC patients. The size of the liver or spleen and the haematocrit of Hb SS patients did not correlate with the
frequency of abdominal pain generally or abdominal VOC specifically.
CONCLUSION: The prevalence rates and patterns of abdominal pain in Hb SS and Hb SC patients appear similar. Abdominal VOC characterised by diffuse/generalised dull abdominal pain occurred in only Hb SS patients and may be a marker of disease severity in these patients.
WAJM 2009; 28(2): 83–86.