Sickle cell disease: hepatobiliary scintigraphy was not very helpful during an abdominal crisis.

Clinical bottom line (level 4)

  1. In patients with sickle cell disease and acute abdominal pain, hepatobiliary scintigraphy was not very helpful in diagnosing acute cholecystitis.
  2. Gallstones were common in patients with sickle cell disease.
Serafini et al: Archives of Internal Medicine 1987; 147: 1061-1062
Expires February 2003

The study

Setting: acute hospital, USA

28 patients (aged range 6 to 33 years, ?% male) sickle cell disease and acute abdominal pain who had hepatobiliary scintigraphy

Independent unblinded reference standard, applied in all patients from a ?consecutive inappropriate spectrum.
Reference standard:
  • hepatobiliary scintigraphy- positive if gallbladder is not visualised at 4 hours
Diagnostic test: clinical signs and symptoms
  • 20 patients had an ultrasound scan, and 90% had gallstones on it.

The evidence


differential diagnosis number of patients prevalence
(95% CI)
positive scintigraphy 9 32.1%
(14.8% to 49.4%)

  • There was no significant difference in clinical findings of aspartate aminotransferase, alanine aminotransferase, bilirubin or white blood cell count.

Comments

  1. 5 out of 11 were patients treated surgically,and only 2 of these had acute cholecystitis- how good a gold standard is this?

Citation

  1. Serafini AN, Spoliansky G, Sfakianakis GN, et al: Diagnostic studies in patients with sickle cell anemia and acute abdominal pain. Archives of Internal Medicine 1987; 147: 1061-1062
Search Terms: sickle in Cochrane
Contributor: Chris Ball and Clare Wotton, February 2000
Reviewer:

Clinical Question.
Patient sickle cell disease
Intervention or Exposure clinical signs and symptoms
Comparison hepatobiliary scintigraphy
Outcome acute cholecystitis