Gastroduodenal Perforation in a Child With Sickle Cell Anemia: A Case Report

Gastroduodenal perforation (GDP) is a rare cause of acute abdominal pain in children.

A 12-year-old boy presented with abdominal pain around the periumbilical and epigastric region on 7previous days. His familial history was significant for sickle cell anemia in the mother and minor thalassemia in the father. He had been diagnosed with sickle cell anemia at the age of 4 years and had received blood transfusion and hydroxyurea every month. At physical examination, a distended abdomen and decreased intestinal sounds were seen. Also, he had a history of cholecystectomy (for cholelithiasis). Fecal occult blood was detected, while no Helicobacter pylori antigen was present. Abdominal ultrasound examination revealed splenomegaly and evidence of free fluid. Surgical results showed bile discharge in the abdominal cavity, and perforation of duodenum and pylorus.

Since the symptoms of GDP in children are non-specific, especially in children with sickle cell anemia, it should be considered in these patients with abdominal pain.