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<< Managing Acute Complications Of Sickle Cell Disease In Pediatric Patients

Differential Diagnosis

Acute complications of SCD seen in the emergency department (ED) can pose a diagnostic challenge to emergency clinicians. (See Table 2.)

Vaso-Occlusive Crisis

In children with SCD, pain is most commonly due to VOC. The differential for VOC includes conditions that can produce pain in any child and depends on the history (nature, duration, and quality of the pain) and physical examination. VOC in older children is usually a self-reported, familiar pain. However, atypical limb pain or pain in areas of the chest, flank, and abdomen mandate consideration of other causes of pain seen in SCD, such as avascular necrosis, osteomyelitis, ACS, acute papillary necrosis with urinary obstruction, SCD hepatopathy, cholecystitis, or splenic sequestration. Also consider causes of non–sickle cell-related pathologies such as trauma, constipation, or appendicitis. 

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Last Modified: 07/23/2017
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