Abstract
Hemorrhage in Sickle Cell Disease is not a common clinical entity and is most often limited to central nervous system bleeds, presenting with hemorrhagic stroke or extradural hematomas. We present an adolescent girl with Sickle Cell Disease who presented with acute abdominal pain and was diagnosed to have a spontaneous pelvic hematoma on non contrast CT. The girl had a normal coagulation profile with no other bleeding manifestations except for two episodes of epistaxis. She improved clinically after transfusion, and the pelvic hematoma resolved spontaneously with conservative management. To the best of our knowledge, this is the first reported manifestation of a spontaneous pelvic hematoma in a person with Sickle Cell Disease, presenting as acute abdomen, thus necessitating a high index of clinical suspicion of such an entity and appropriate management of the same.
References
- Serjeant G. R. Sickle-cell disease. The Lancet. 1997;350(90790: 725-730. doi:10. 1016/s0140-6736(97)07330-3 [PubMed]
- Modell B., Darlison M. Global epidemiology of haemoglobin disorders and derived service indicators. Bulletin of the World Health Organisation. 2008;86 (6):480-487. doi:10.2471/blt.06.036673. [PubMed]
- Novelli EM, Gladwin MT. Crises in Sickle Cell Disease. Chest.2016 Apr;149 (4): 1082-93. doi: 10.101/j.chest.2015.12.016.Epub 2015 Dec 28 [PubMed]
- Ohene-Frempong K, Weiner SJ, Sleeper LA, et al. ‘Cerebrovascular accidents in sickle cell disease: rates and risk factors. Blood 1998;91:288-94 [PubMed]
- Guedenon KM, Gbadoe AD, Nouwakpo NB. ‘Gross hematuria in sickle cell disease at Tokoin teaching hospital in Lome (Togo)
- Powars D, Adams RJ, Nichols FT, et al. Delayed intracranial haemorrhage following cerebral infarction in Sickle Cell Disease (1990). J Assoc Acad Minor Phys 1998; 1:79-82 [PubMed]
- Diggs LW, Bookoff D. Multiple cerebral aneurysms in patients with sickle cell disease, South Med J 1993;86-377-9 [PubMed]
- Henderson JN, Noetzel MJ, McKinstry RC, et al.. Reversible posterior leucoencephalopathy syndrome and silent cerebral infarcts are associated with severe acute chest syndrome in children with sickle cell disease. Blood 2003;101:415-19 [PubMed]
- Royal JE, Seeler RA. . Hypertension, convulsions, and cerebral haemorrhage in sickle-cell anaemia patients after blood transfusion Lancet 1978;2:1207. [PubMed]
- Catherine P, Kate Gardner, Sue Height, et al. . Nontraumatic extradural hematoma in Sickle Cell Disease: A rare neurological complication not to be missed. American Journal of Hematology Feb2014; 225-227. doi:10.1002/ajh.23579
- Dahdeleh NS, Lindley TE, Kirby PA, et al.. A ‘neurological crisis’ of sickle cell disease. J Neurosurg Paediatr 2009;4:532-535.
- Michael Alton. Renal Abnormalities in Sickle Cell Disease. JAMA, March 1990; 150(3):501-504. don:10.1001/archnite.1990.00390150015003.
- Uqalde D, Conte G, Uqalde H, et al. . Sub capsular splenic hematoma in a sickle cell trait carrier. Rev Med Chil. 2011 Sep;139(9):1192-5. doi: /S0034-98872011000900012. Pub 2011 Nov 17.
Corresponding Author
Dr Royson Dsouza
PG Registrar- Division of Surgery Christian Medical College, Vellore Vellore- 632004, Tamil Nadu, India
Ph- +91 99646 99591, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i10.42
