Ischemic duodenal ulcer, an unusual presentation of sickle cell disease.
Sickle cell disease is caused by molecular abnormalities in the formation of hemoglobin, leading to pain crisis from recurrent vascular occlusion by sickled hemoglobin. Impaired flow in the microvasculature can lead to ischemia, tissue infarction and ulceration. Abdominal pain, a common complaint in sickle cell disease, can be due to an uncommon etiology, ischemic duodenal ulceration. This is due to primary mucosal infarction caused by sickling, leading to poor healing of infarcted areas. Prompt endoscopic and/or urgent surgical intervention should be considered, particularly if anticoagulation is an issue, as proton pump inhibitor use is ineffective in healing this type of ulcer.
Julka
Rahul N
RN
Division of Gastroenterology, University of Arkansas for Medical Sciences, Fayette, AR, USA.
Aduli
Farshad
F
Lamps
Laura W
LW
Olden
Kevin W
KW
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D001741:Black or African American; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D004381:Duodenal Ulcer / Q000209:etiology* / Q000473:pathology; D004386:Duodenum / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D007511:Ischemia / Q000209:etiology* / Q000473:pathology; D011655:Pulmonary Embolism / Q000209:etiology; D012307:Risk Factors; D014481:United States