Acute splenic infarction following air travel in a child with Hb SD disease

Abstract

Objective: The relative hypoxia, dehydration and immobility associated with air travel predispose sickle cell disease patients to acute splenic crises; however we are not aware of previous reports involving children with Hb SD. Clinical Presentation: We report on a previously healthy 2-year-old Kuwaiti girl who developed a sudden onset of severe abdominal pain while traveling on a commercial jet aircraft. This was followed by vomiting and fever. On examination in the emergency room she was very irritable with abdominal tenderness maximal over the left hypochondrium. The spleen was palpable 7 cm below the costal margin, and abdominal ultrasonography and CAT scan confirmed a diagnosis of acute splenic infarction. Hematological investigations showed that the patient was a compound heterozygote for Hbs S and D. Intervention: The patient was managed with intravenous fluids and analgesics and made a full recovery. Conclusion: Acute splenic infarction should be considered in the differential diagnosis of a sudden onset of abdominal pain associated with air travel in patients with Hb SD.