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E1685. Abdominal Manifestations of Sickle Cell Disease
Authors
  1. Timothy Hagan; University of Texas Southwestern
  2. Vasantha Vasan; University of Texas Southwestern
  3. Andrews Sajan; University of Texas Southwestern
Background
Sickle cell disease (SCD) is the most prevalent hemoglobinopathy. These patients experience a lifetime of repeated acute pain crises, which are thought to result from sickling and microvascular occlusions with repeated crises leading to organ dysfunction, such as asplenia, hepatic failure, and renal failure. The spleen, liver, biliary system, kidneys, and gastrointestinal tract can all be affected. We review the spectrum of CT imaging findings of abdominal manifestations with SCD, from the acute microvascular occlusive pain crisis to the potential complications and chronic sequelae.

Educational Goals / Teaching Points
Comprehensive review of acute and chronic disease manifestations and complications that can be seen with SCD on CT and clinical findings to aid in a specific diagnosis will be discussed. Organ specific manifestations of SCD involving the liver (eg, hepatopathy, iron deposition), gallbladder (eg, stone formation), spleen (eg, infarction, abscess formation, sequestration), kidneys (eg, papillary necrosis, infarction), pancreas (eg, pancreatitis), gastrointestinal tract (eg, infarction), reproductive organs (eg, priapism, testicular atrophy), bone (eg, marrow changes, avascular necrosis), vasculature (eg, vasculopathy), and lung bases (eg, acute chest syndrome, infarction).

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Characteristic CT findings in multiple organ systems will be reviewed, including liver (eg, hepatopathy, iron deposition), gallbladder (eg, stone formation), spleen (eg, infarction, abscess formation, sequestration), kidneys (eg, papillary necrosis, infarction), pancreas (eg, pancreatitis), gastrointestinal tract (eg, infarction), reproductive organs (eg, priapism, testicular atrophy), bone (eg, marrow changes, avascular necrosis), vasculature (eg, vasculopathy), and lung bases (eg, acute chest syndrome, infarction).

Conclusion
Abdominal pain in sickle cell disease may present in different ways and it is important to recognize that the possible diagnoses are numerous. Not all cases are due to vaso-occlusive crises. Early diagnosis and prompt treatment can be lifesaving.