Introduction

Sickle Cell disease (SCD) is a disabling condition usually arising from inheritance, carries a turbulent lifespan with occult or overt manifestations of its complications. These complications may at times calls for an emergency management of its complications. Vaso occlusive crisis in sickle cell anemia is responsive for majority of surgical complications like chronic leg ulcer, priapism, osteomyelitis, splenomegaly, acute abdominal pain, cholecystitis. With these pathology the sickle cell disease patients present before the surgeons, it can affect any part of the body & one of the most common and  early organ to be affected in SCD is Spleen .Spleen can over functions resulted in fall in all blood component¹, in its milder and usually more chronic form  as hypersleenism. Spleenectomy is done for varities of reasons including acute spleenic sequestration crisis hyperspleenism, Spleenic abscess^2,5-8. Spleenectomy may be done either open & laparascopic method^3,4. Lap. splneectomy is safe & effective¹⁰. There is also quantitative improvement in blood indices such as Hb%, Plt. count, mcv etc in post  spleenectomy ⁹ & with improvement of immunization & penicillin prophylaxis ,the relative risk from removal of spleen have probably decreased¹¹ .it is commonly in larged in 1^st decade of life. spleenectomy in SCD patient with hyperspleenism to be beneficial in decreasing their transfusion requirement & discomfort from mechanical pressure of in larged spleen

1. Owusu-Ofori S, Hirst C. Splenectomy versus conservative management for acute 3. Al-Salem AH. Indications and complications of splenectomy for children with sickle cell disease. J Pediatr Surg. 2006;41:1909–15. http://dx.doi.org/10.1016/j.jpedsurg.2006.06.020 . PMid:17101369. [PubMed]
2. sequestration crises in people with sickle cell disease. Cochrane database Syst Rev. 2013;31(5):CD003425. [PubMed]
3. Ziegler M, Azizkhan RG, von Allmen D, Weber T. Operative Pediatric Surgery. McGraw Hill Professional. 2014
4. CoranA, Scoot Adzick N, Krummel T, Laberger J, Shamberger R, Caldamone A. Pediatric surgery. 7^th Elsevier; 2012.
5. Buck J, Davies SC. Surgery in sickle cell disease. Hematol Oncol Clin North Am. 2005;19:897–902. http://dx.doi.org/10.1016/j.hoc.2005.07.004 . PMid:16214650. [PubMed]
6. Holterman AX, Adams KN, Seeler RA. Surgical management of pediatric hematologic disorders.SurgClin North Am. 2006;86:427–439. http://dx.doi.org/10.1016/j.suc.2005.12.004 . PMid:16580932. [PubMed]
7. Rescorla FJ. The spleen. In: Grosfeld JL, O’Neill JA Jr, Fonkalsrud EW, et al., editors. Pediatricsurgery. 6th ed. Philadelphia (Pa): Mosby Elsevier; 2006. pp. 1691–700. http://dx.doi.org/10.1016/B978-0-323-02842-4.50111-X .
8. Sounthararajah Y, Vichinsky E, Embury SH. Sickle cell disease. In: Hoffman R, Benz EJ, Shattil SJ, et al., editors. Hoff-man: hematology:basic principles and pra-ctice. 4th ed. Philadelphia (Pa): Churchill Livingstone (Elsevier); 2005. pp. 605–3.
9. Jastaniah W. Epidemiology of sickle cell disease in Saudi Arabia Ann. Saudi Med. 2011;31(3):289–293. [PMC free article] [PubMed]
10. Murawski M, Patkowski D, Korlacki W, et al. Laparoscopic splenectomy in children a multicenter experience. J Pediatr Surg. 2008;43:951–4. http://dx.doi.org/10.1016/j.jpedsurg.2007.11.040 . PMid:18485976. [PubMed]
11. Kokoska ER, West KW, Carney DE, et al. Risk factors for acute chest syndrome in children with sickle cell disease undergoing abdominal surgery. J Pediatr Surg. 2004;39:848–50. http://dx.doi.org/10.1016/j.jpedsurg.2004.02.027 . PMid:15185210. [PubMed]
12. Serjeant GR .Sickle cell disease. Lancet1997;350;725-730(pub med)
13. Hendricks-Feguson V,NELSON MA. Treatment of cholelithiasisin children in SCD.AORN.2003;77;1170-1182.
14. Gumiero A.P., Bellomo-Brandão M.A., Costa-Pinto E.A. Gallstones in children with sickle cell disease followed up at a Brazilian hematology center. Arq Gastroe-nterol. 2008;45(4):313–318. [PubMed]
15. Traina F., Saad S.T. Complicações hepaticas na doença falciforme. Rev Bras Hematol Hemoter. 2007;29 (3):299–303.
16. Dan D., Seetahal S., Harnanan D., Singh Y., Hariharan S., Naraynsingh V. Laparoscopic cholecystectomy in sickle cell disease patients: does operating time matter? Int J Surg. 2009;7(1):70–73. [PubMed]
17. Leandros E., Kymionis G.D., Konstadoulakis M.M., Albanopoulos K., Dimitrakakis K., Gomatos I. Laparoscopic or open cholecystectomy in patients with sickle cell disease: which approach is superior? Eur J Surg. 2000;166(11):859–861. [PubMed]
18. Al-Salem A.H., Nourallah H. Sequential endoscopic/laparoscopic management of cholelithiasis and choledocholithiasis in children who have sickle cell disease. J Pediatr Surg. 1997;32(10):1432–1435. [PubMed]
19. Tagge E.P., Othersen H.B., Jr., Jackson S.M., Smith C.D., Gayoso A.J., Abboud M.R. Impact of laparoscopic cholecystectomy on the management of cholelithiasis in children with sickle cell disease. J Pediatr Surg. 1994;29(2):209–212. [PubMed]
20. Meshikhes A.N., al-Dhurais S.A., al-Jama A., al-Faraj A.A., al-Khatir N.S., al-Abkar H. Laparoscopic cholecystectomy in patients with sickle cell disease. J R CollSurgEdinb. 1995;40(6):383–385. [PubMed]
21. Muroni M., Loi V., Lionnet F., Girot R., Houry S. Prophylactic laparoscopic cholecystectomy in adult sickle cell disease patients with cholelithiasis: a prospective cohort study. Int J Surg. 2015;22:62–66. [PubMed]
22. Friedrich J.R. Cirugia e Anestesia na doençafalciforme. Rev Bras Hematol Hemoter. 2007;29(3):304–308.

Dr A. K. Behera

Assistant Professor, Department of General Surgery, VIMSAR, Burla, Odisha

Contact No. 9437303084, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.