Sickle cell diseases and ileus.

Background: We tried to understand whether or not there is an increased incidence of ileus in patients with sickle cell diseases (SCDs).

Methods: All cases with SCDs were taken into the study.

Results: The study included 325 patients (160 females). The mean ages were similar in both sexes (29.3 versus 29.8 years in females and males, respectively, p > 0.05). Incidence of ileus was higher in males, significantly (3.6% versus 1.2%, p < 0.01). All of the ileus cases were able to be treated with simple and repeated red blood cell (RBC) transfusions without any surgical procedure. Smoking was higher in males, too (21.8% versus 6.2%, p < 0.001). The mean hematocrit value was also higher in males, significantly (24.4% versus 23.0%, p = 0.016). RBC units transfused, digital clubbing, leg ulcers, pulmonary hypertension, chronic obstructive pulmonary disease, coronary heart disease, and chronic renal disease were all higher in males, too (p < 0.05 for all). On the other hand, although the general mortality, white blood cell and platelet counts of peripheric blood, painful crises per year, rheumatic heart disease, avascular necrosis of bone, cirrhosis, and stroke were all higher in males, the differences were nonsignificant probably due to the small sample sizes of the groups (p > 0.05 for all).

Conclusion: Although the relatively young mean ages of the patients with SCDs, the very high incidences of ileus are probably due to the strong atherosclerotic and obstructive natures of the two pathologies, and ileus should be treated with simple and repeated RBC transfusions to restore bowel perfusion in such patients.