[Severe upper abdominal pain during a long distance flight].
Identifieur interne : 000153 ( Main/Exploration ); précédent : 000152; suivant : 000154[Severe upper abdominal pain during a long distance flight].
Auteurs : D. Bestehorn [Allemagne] ; C. Schmidt [Allemagne] ; G. Lock [Allemagne]Source :
- Deutsche medizinische Wochenschrift (1946) [ 1439-4413 ] ; 2014.
Descripteurs français
- KwdFr :
- Abdomen aigu (thérapie), Abdomen aigu (étiologie), Adulte (MeSH), Allemagne (MeSH), Diagnostic différentiel (MeSH), Drépanocytose (diagnostic), Dépistage des porteurs génétiques (MeSH), Femelle (MeSH), Ghana (ethnologie), Humains (MeSH), Infarctus splénique (diagnostic), Recueil de l'anamnèse (MeSH), Voyage aérien (MeSH), alpha-Thalassémie (diagnostic), Échographie (MeSH).
- MESH :
- diagnostic : Drépanocytose, Infarctus splénique, alpha-Thalassémie.
- ethnologie : Ghana.
- thérapie : Abdomen aigu.
- étiologie : Abdomen aigu.
- Adulte, Allemagne, Diagnostic différentiel, Dépistage des porteurs génétiques, Femelle, Humains, Recueil de l'anamnèse, Voyage aérien, Échographie.
English descriptors
- KwdEn :
- Abdomen, Acute (etiology), Abdomen, Acute (therapy), Adult (MeSH), Air Travel (MeSH), Anemia, Sickle Cell (diagnosis), Diagnosis, Differential (MeSH), Female (MeSH), Genetic Carrier Screening (MeSH), Germany (MeSH), Ghana (ethnology), Humans (MeSH), Medical History Taking (MeSH), Splenic Infarction (diagnosis), Ultrasonography (MeSH), alpha-Thalassemia (diagnosis).
- MESH :
- diagnosis : Anemia, Sickle Cell, Splenic Infarction, alpha-Thalassemia.
- ethnology : Ghana.
- etiology : Abdomen, Acute.
- therapy : Abdomen, Acute.
- Adult, Air Travel, Diagnosis, Differential, Female, Genetic Carrier Screening, Germany, Humans, Medical History Taking, Ultrasonography.
Abstract
HISTORY AND CLINICAL FINDINGS
A 43-year-old woman of Ghanaian origin presented with severe upper abdominal pain starting on a long distance flight. Physical examination revealed tenderness on palpation in the left upper abdomen and flank. There was no report of pre-existing conditions or permanent medication in the medical history.
INVESTIGATIONS AND DIAGNOSIS
Laboratory tests showed signs of haemolytic anemia and elevated inflammatory parameters. The "thick blood smear" was normal. Ultrasonography revealed an enlarged spleen (14×5 cm) with inhomogeneous parenchyma and vast, diffusely spread hypoechoic lesions in perihilar location, interpreted as extended splenic infarction. Symptom onset on a long distance flight, haemolytic anemia and extended splenic infarction led to the assumption of a vasoocclusive crisis with haemolysis. Moleculargenetic tests proved the presence of HbSC-sickle cell disease and heterozygous alpha-thalassemia.
TREATMENT AND COURSE
After infusion of crystalloid solution the patient was asymptomatic further on. Due to splenic infarction she received prophylactic treatment with Cefuroxim. A vaccination against pneumococci, meningococci and Haemophilus influenza B was recommended.
CONCLUSIONS
Mild hypoxia and dehydration on a long distance flight can trigger a sickle cell crisis and may contribute to late clinical manifestation and diagnosis of sickle cell disease in some cases. Patients suffering from HbSC-sickle cell disease are at risk for the same life-threatening complications as patients with HbSS-sickle cell disease. HbSC-sickle cell disease should not be considered as a mild form of HbSS-sickle cell disease but as a separate disease with specific clinical manifestations. In contrast-enhanced ultrasonography, splenic infarction due to sickle cell crisis may markedly differ from "typical" arterial thromboembolic infarction.
DOI: 10.1055/s-0034-1370287
PubMed: 25254402
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Schmidt</name><affiliation wicri:level="3"><nlm:affiliation>Klinik für Innere Medizin, Albertinen-Krankenhaus, Hamburg.</nlm:affiliation><country>Allemagne</country><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName><wicri:orgArea>Klinik für Innere Medizin, Albertinen-Krankenhaus</wicri:orgArea></affiliation></author><author><name sortKey="Lock, G" sort="Lock, G" uniqKey="Lock G" first="G" last="Lock">G. Lock</name><affiliation wicri:level="3"><nlm:affiliation>Klinik für Innere Medizin, Albertinen-Krankenhaus, Hamburg.</nlm:affiliation><country>Allemagne</country><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName><wicri:orgArea>Klinik für Innere Medizin, Albertinen-Krankenhaus</wicri:orgArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2014">2014</date><idno type="RBID">pubmed:25254402</idno><idno type="pmid">25254402</idno><idno type="doi">10.1055/s-0034-1370287</idno><idno type="wicri:Area/Main/Corpus">000155</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000155</idno><idno type="wicri:Area/Main/Curation">000155</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000155</idno><idno type="wicri:Area/Main/Exploration">000155</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Severe upper abdominal pain during a long distance flight].</title><author><name sortKey="Bestehorn, D" sort="Bestehorn, D" uniqKey="Bestehorn D" first="D" last="Bestehorn">D. Bestehorn</name><affiliation wicri:level="3"><nlm:affiliation>Klinik für Innere Medizin, Albertinen-Krankenhaus, Hamburg.</nlm:affiliation><country>Allemagne</country><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName><wicri:orgArea>Klinik für Innere Medizin, Albertinen-Krankenhaus</wicri:orgArea></affiliation></author><author><name sortKey="Schmidt, C" sort="Schmidt, C" uniqKey="Schmidt C" first="C" last="Schmidt">C. Schmidt</name><affiliation wicri:level="3"><nlm:affiliation>Klinik für Innere Medizin, Albertinen-Krankenhaus, Hamburg.</nlm:affiliation><country>Allemagne</country><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName><wicri:orgArea>Klinik für Innere Medizin, Albertinen-Krankenhaus</wicri:orgArea></affiliation></author><author><name sortKey="Lock, G" sort="Lock, G" uniqKey="Lock G" first="G" last="Lock">G. Lock</name><affiliation wicri:level="3"><nlm:affiliation>Klinik für Innere Medizin, Albertinen-Krankenhaus, Hamburg.</nlm:affiliation><country>Allemagne</country><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName><wicri:orgArea>Klinik für Innere Medizin, Albertinen-Krankenhaus</wicri:orgArea></affiliation></author></analytic><series><title level="j">Deutsche medizinische Wochenschrift (1946)</title><idno type="eISSN">1439-4413</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Abdomen, Acute (etiology)</term><term>Abdomen, Acute (therapy)</term><term>Adult (MeSH)</term><term>Air Travel (MeSH)</term><term>Anemia, Sickle Cell (diagnosis)</term><term>Diagnosis, Differential (MeSH)</term><term>Female (MeSH)</term><term>Genetic Carrier Screening (MeSH)</term><term>Germany (MeSH)</term><term>Ghana (ethnology)</term><term>Humans (MeSH)</term><term>Medical History Taking (MeSH)</term><term>Splenic Infarction (diagnosis)</term><term>Ultrasonography (MeSH)</term><term>alpha-Thalassemia (diagnosis)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Abdomen aigu (thérapie)</term><term>Abdomen aigu (étiologie)</term><term>Adulte (MeSH)</term><term>Allemagne (MeSH)</term><term>Diagnostic différentiel (MeSH)</term><term>Drépanocytose (diagnostic)</term><term>Dépistage des porteurs génétiques (MeSH)</term><term>Femelle (MeSH)</term><term>Ghana (ethnologie)</term><term>Humains (MeSH)</term><term>Infarctus splénique (diagnostic)</term><term>Recueil de l'anamnèse (MeSH)</term><term>Voyage aérien (MeSH)</term><term>alpha-Thalassémie (diagnostic)</term><term>Échographie (MeSH)</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Anemia, Sickle Cell</term><term>Splenic Infarction</term><term>alpha-Thalassemia</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Drépanocytose</term><term>Infarctus splénique</term><term>alpha-Thalassémie</term></keywords><keywords scheme="MESH" qualifier="ethnologie" xml:lang="fr"><term>Ghana</term></keywords><keywords scheme="MESH" qualifier="ethnology" xml:lang="en"><term>Ghana</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Abdomen, Acute</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Abdomen, Acute</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Abdomen aigu</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Abdomen aigu</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Air Travel</term><term>Diagnosis, Differential</term><term>Female</term><term>Genetic Carrier Screening</term><term>Germany</term><term>Humans</term><term>Medical History Taking</term><term>Ultrasonography</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Allemagne</term><term>Diagnostic différentiel</term><term>Dépistage des porteurs génétiques</term><term>Femelle</term><term>Humains</term><term>Recueil de l'anamnèse</term><term>Voyage aérien</term><term>Échographie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>HISTORY AND CLINICAL FINDINGS</b></p><p>A 43-year-old woman of Ghanaian origin presented with severe upper abdominal pain starting on a long distance flight. Physical examination revealed tenderness on palpation in the left upper abdomen and flank. There was no report of pre-existing conditions or permanent medication in the medical history.</p></div><div type="abstract" xml:lang="en"><p><b>INVESTIGATIONS AND DIAGNOSIS</b></p><p>Laboratory tests showed signs of haemolytic anemia and elevated inflammatory parameters. The "thick blood smear" was normal. Ultrasonography revealed an enlarged spleen (14×5 cm) with inhomogeneous parenchyma and vast, diffusely spread hypoechoic lesions in perihilar location, interpreted as extended splenic infarction. Symptom onset on a long distance flight, haemolytic anemia and extended splenic infarction led to the assumption of a vasoocclusive crisis with haemolysis. Moleculargenetic tests proved the presence of HbSC-sickle cell disease and heterozygous alpha-thalassemia.</p></div><div type="abstract" xml:lang="en"><p><b>TREATMENT AND COURSE</b></p><p>After infusion of crystalloid solution the patient was asymptomatic further on. Due to splenic infarction she received prophylactic treatment with Cefuroxim. A vaccination against pneumococci, meningococci and Haemophilus influenza B was recommended.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Mild hypoxia and dehydration on a long distance flight can trigger a sickle cell crisis and may contribute to late clinical manifestation and diagnosis of sickle cell disease in some cases. Patients suffering from HbSC-sickle cell disease are at risk for the same life-threatening complications as patients with HbSS-sickle cell disease. HbSC-sickle cell disease should not be considered as a mild form of HbSS-sickle cell disease but as a separate disease with specific clinical manifestations. In contrast-enhanced ultrasonography, splenic infarction due to sickle cell crisis may markedly differ from "typical" arterial thromboembolic infarction.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25254402</PMID><DateCompleted><Year>2014</Year><Month>11</Month><Day>21</Day></DateCompleted><DateRevised><Year>2017</Year><Month>11</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1439-4413</ISSN><JournalIssue CitedMedium="Internet"><Volume>139</Volume><Issue>40</Issue><PubDate><Year>2014</Year><Month>Oct</Month></PubDate></JournalIssue><Title>Deutsche medizinische Wochenschrift (1946)</Title><ISOAbbreviation>Dtsch. Med. Wochenschr.</ISOAbbreviation></Journal><ArticleTitle>[Severe upper abdominal pain during a long distance flight].</ArticleTitle><Pagination><MedlinePgn>2026-9</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1055/s-0034-1370287</ELocationID><Abstract><AbstractText Label="HISTORY AND CLINICAL FINDINGS" NlmCategory="METHODS">A 43-year-old woman of Ghanaian origin presented with severe upper abdominal pain starting on a long distance flight. Physical examination revealed tenderness on palpation in the left upper abdomen and flank. There was no report of pre-existing conditions or permanent medication in the medical history.</AbstractText><AbstractText Label="INVESTIGATIONS AND DIAGNOSIS" NlmCategory="METHODS">Laboratory tests showed signs of haemolytic anemia and elevated inflammatory parameters. The "thick blood smear" was normal. Ultrasonography revealed an enlarged spleen (14×5 cm) with inhomogeneous parenchyma and vast, diffusely spread hypoechoic lesions in perihilar location, interpreted as extended splenic infarction. Symptom onset on a long distance flight, haemolytic anemia and extended splenic infarction led to the assumption of a vasoocclusive crisis with haemolysis. Moleculargenetic tests proved the presence of HbSC-sickle cell disease and heterozygous alpha-thalassemia.</AbstractText><AbstractText Label="TREATMENT AND COURSE" NlmCategory="METHODS">After infusion of crystalloid solution the patient was asymptomatic further on. Due to splenic infarction she received prophylactic treatment with Cefuroxim. A vaccination against pneumococci, meningococci and Haemophilus influenza B was recommended.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Mild hypoxia and dehydration on a long distance flight can trigger a sickle cell crisis and may contribute to late clinical manifestation and diagnosis of sickle cell disease in some cases. Patients suffering from HbSC-sickle cell disease are at risk for the same life-threatening complications as patients with HbSS-sickle cell disease. HbSC-sickle cell disease should not be considered as a mild form of HbSS-sickle cell disease but as a separate disease with specific clinical manifestations. In contrast-enhanced ultrasonography, splenic infarction due to sickle cell crisis may markedly differ from "typical" arterial thromboembolic infarction.</AbstractText><CopyrightInformation>© Georg Thieme Verlag KG Stuttgart · New York.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Bestehorn</LastName><ForeName>D</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Klinik für Innere Medizin, Albertinen-Krankenhaus, Hamburg.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schmidt</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Klinik für Innere Medizin, Albertinen-Krankenhaus, Hamburg.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lock</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Klinik für Innere Medizin, Albertinen-Krankenhaus, Hamburg.</Affiliation></AffiliationInfo></Author></AuthorList><Language>ger</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><VernacularTitle>Heftige Oberbauchbeschwerden während eines Langstreckenfluges.</VernacularTitle><ArticleDate DateType="Electronic"><Year>2014</Year><Month>09</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Dtsch Med Wochenschr</MedlineTA><NlmUniqueID>0006723</NlmUniqueID><ISSNLinking>0012-0472</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000006" MajorTopicYN="N">Abdomen, Acute</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D064870" MajorTopicYN="Y">Air Travel</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000755" MajorTopicYN="N">Anemia, Sickle Cell</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003937" MajorTopicYN="N">Diagnosis, Differential</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006580" MajorTopicYN="N">Genetic Carrier Screening</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005858" MajorTopicYN="N">Germany</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005869" MajorTopicYN="N">Ghana</DescriptorName><QualifierName UI="Q000208" MajorTopicYN="N">ethnology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008487" MajorTopicYN="N">Medical History Taking</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013159" MajorTopicYN="N">Splenic Infarction</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014463" MajorTopicYN="N">Ultrasonography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017085" MajorTopicYN="N">alpha-Thalassemia</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2014</Year><Month>9</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>9</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2014</Year><Month>12</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">25254402</ArticleId><ArticleId IdType="doi">10.1055/s-0034-1370287</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li></country><region><li>Hambourg</li></region><settlement><li>Hambourg</li></settlement></list><tree><country name="Allemagne"><region name="Hambourg"><name sortKey="Bestehorn, D" sort="Bestehorn, D" uniqKey="Bestehorn D" first="D" last="Bestehorn">D. Bestehorn</name></region><name sortKey="Lock, G" sort="Lock, G" uniqKey="Lock G" first="G" last="Lock">G. Lock</name><name sortKey="Schmidt, C" sort="Schmidt, C" uniqKey="Schmidt C" first="C" last="Schmidt">C. Schmidt</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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