Sonographic evaluation of some abdominal organs in sickle cell disease patients in a tertiary health institution in Northeastern Nigeria

Abstract

Background:Sonographic evaluation of abdominal organs is an important work up in managing sickle cell disease (SCD) patients. This study aimed at evaluating abdominal organs by sonography among SCD patients.Methodology:A cross-sectional study was carried out in Maiduguri, Nigeria from April 2014 to July 2015. Two hundred and fifty-two patients participated in the study, with 126 controls and 126 SCD patients. There were 131 (52%) males, and 121 (48%) females, with age range 3–38 years. Measurements were done using ultrasound machine with probe frequencies ranging from 1–4MHz and 4–9MHz in supine, right and left oblique positions for optimum visualization of the abdominal organs.Results:Participants within the age range of 10–15 years had the highest frequency with 88 (34.9%), followed by those within the age group of 17–23 years with 86 (34.1%), and the least were those within the age group of 30 years and above with 8 (3.2%). Hepatomegaly was found in 53 (75.7%), and increased echogenicity of the liver was found in 50 (94.3%) of the SCD patients, P = 0.000. Gallstones were found in 45 (17.9%), gallbladder sludge was found in 51 (21.4%) and thickened gallbladder wall was found in 84 (33.3%) of the SCD patients, P = 0.000. Autosplenectomy was found in 45 (17.9%), splenomegaly in 63 (24.9%), and calcified spleen in 18 (8.7%) of the SCD patients, P = 0.000. Enlarged kidneys in SCD patients were found in 61 (98.4%) and 63 (98.4%) on the right and left kidneys, respectively. Shrunken kidneys were found in 5 (2.0%) and 4 (1.6%) of the SCD patients on the right and left kidneys, respectively, P = 0.000.Conclusion:Abdominal sonography in SCD patients revealed varied remarkable changes in the size, echotexture, intraluminal deposits and wall thickness in the liver, gallbladder, kidneys, and spleen.

Pattern of Renal Blood Flow and Renovascular Parameters in Adult Patients With Sickle Cell Disease

“…Our findings were consistent with previous reports in terms of renal length but not cortical echogenicty. 17,29,30 The increase in cortical echogenicity in this study could have been due to many variables, such as the experience of the US operator, sample size, type of US machine, and stage of disease progression. Other factors include multiple small scatter reflectors from vascular intimal hyperplasia, thrombosis, higher blood flow in anemic patients, and the presence of microvascular sickled red blood cells.…”

“…Moreover, 59 (90.8%) patients had mildly diffuse increased cortical echogenicity with preserved renal cortical thickness, and 6 (9.2%) had normal cortical echogenicity and thickness. Our findings were consistent with previous reports in terms of renal length but not cortical echogenicty . The increase in cortical echogenicity in this study could have been due to many variables, such as the experience of the US operator, sample size, type of US machine, and stage of disease progression.…”

Comment on sonographic evaluation of abdominal organs in sickle cell disease

“…We read the publication on “sonographic evaluation of some abdominal organs in sickle cell disease (SCD) patients in a tertiary health institution in Northeastern Nigeria” with a great interest. [1] Luntsi et al . reported that “abdominal sonography in SCD patients revealed varied remarkable changes in the size, echotexture, intraluminal deposits, and wall thickness in the liver, gallbladder, kidneys, and spleen.”[1] We would like to share the ideas on this report.…”

“…[1] Luntsi et al . reported that “abdominal sonography in SCD patients revealed varied remarkable changes in the size, echotexture, intraluminal deposits, and wall thickness in the liver, gallbladder, kidneys, and spleen.”[1] We would like to share the ideas on this report. First, without screening for other common diseases such as hepatitis or metabolic disease, the finding might be the result from other confounding disorders.…”

Reply to comment on sonographic evaluation of abdominal organs in sickle cell disease

“…In our study, we reported that “Assessment of abdominal organs such as the liver, gallbladder, spleen, and kidneys by ultrasound among sickle cell disease (SCD) patients revealed varied remarkable changes in these organ sizes, echotexture, intraluminal deposits, and wall thickness among the studied patients. Abdominal sonography is an easy, affordable, readily available, accurate, and noninvasive diagnostic tool for early detection of organ changes for further management and follow-up of SCD patients.”[1]…”