Pseudocyst of Pancreas, Rare Crisis in Sickle Cell Disease.

ABSTRACT

Sickle cell syndrome is an inherited autosomal recessive disease which results in the production of abnormal haemoglobin S due to a point mutation in the beta globin gene that changes the sixth amino acid from glutamic acid to valine (α2β2 6 Glu→Val).[1] These deformed RBCs cause vaso-occlusion, tissue ischemia, and infarction leading to clinical manifestations. About 10% of sickle cell patients present with acute abdominal pain, which may be due to acute cholecystitis, acute pancreatitis (rare), peptic ulcer disease, constipation due to opioids, hepatic and splenic sequestration, urinary tract infections and ischaemic bowel.[2,3,4]On literature search, not a single case of pseudo pancreatic cyst as a complication of sickle cell disease has been reported. We present a rare case of vaso-occlusive crisis in a 40 year old male patient with sickle cell anaemia leading to acute ischemic pancreatitis which may not be identified at initial stages as he was treated with fluids for sickle cell crisis similar to acute pancreatitis later on diagnosed as pseudo cyst pancreas.Pancreatic pseudocyst in a sickle cell disease is commonly misdiagnosed as sickle cell crisis hence causing difficulty in establishing the diagnosis, especially if abdominal pain is the presenting complaint. We present a case of 40-year-old non-alcoholic male having complaints of pain abdomen, misdiagnosed as peptic ulcer disease turned out to be pseudocyst of pancreas on ultrasonography of abdomen.