Sunday, January 20, 2008

Sunday January 20, 2008
Resistant Sickle cell crisis !

Scenario: 28 year old male with history of sickle cell crisis presented with priapism. 6 hours past and despite adequate hydration and analgesia, there is no relief ! What is your next option ?

Answer: In case of priapism, you have 2 options. Either call an urologist for aspiration of corpus cavernosum or consult a hematologist for exchange blood transfusion.

Exchange blood transfusion in sickle cell crisis should be consider in following situations:

  • No relief in crisis despite adequate hydration and analgesia
  • Any sign of stroke
  • Pregnancy
  • Prophylactic exchange transfusion prior to major surgery. A single exchange transfusion reduces the risk of complications from the general anaesthetic and surgery
  • C/O loss of vision in one eye or visual symptoms
  • Unresolved painful erection of the penis (priapism)

References: Click to get abstracts / articles

1. Anemia, Sickle Cell,

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