Acute Pancreatitis in the Setting of Vaso-Occlusive Sickle Cell Crisis: A Rare Differential Diagnosis

Sickle cell disease(SCD) is a hemoglobinopathy characterized by chronic hemolyticanemia and vaso-occlusive painful crisis. The vascular occlusion in SCD is a complex process that is responsible for most clinical manifestations of the disease. Abdominal pain is an important component of vaso-occlusive painful crisis and may mimic diseases, such as acute appendicitis and cholecystitis. Acute pancreatitis is rarely encountered as a cause of abdominal pain in patients with SCD. Gallstones and alcohol abuse account for the majority of the cases of acute pancreatitis. Pancreatic ischemia is an uncommon but established cause of pancreatitis associated with connective tissue diseases, vasculitis, and shock. In SCD, the deformed red blood cellsresulting from deoxygenation during stress, infection or dehydration, cause vaso-occlusion, tissue ischemia, and infarction. We present a case of SCDpresenting as acute pancreatitis apparently due to microvascular occlusion and ischemic injury to the pancreas. The patient responded to conservative management. Our case will help to always keep in mind and consider acute pancreatitis as a differential diagnosis in patients with SCD presenting with abdominal pain.