Chronic hepatomegaly in steady state haemoglobin S children: some clinical and abdominal duplex ultrasonographic observations
Adeodu, O.O.; Adetiloye, V.A.; Dairo, B.A.
West African Journal of Medicine 20(3): 208-213
2001
ISSN/ISBN: 0189-160X PMID: 11922152 Document Number: 6328
Chronic hepatomegaly (CH) is an index of severe disease in children with sickle cell anaemia (HbS). We studied 14HbS children with CH and two groups of controls made up of age and sex-matched HbA and HbS children without CH. The objective was to determine and compare hepatic perfusions in the children and also determine which clinical and ultrasonographic features are associated with CH. Hepatic perfusion was assessed using abdominal duplex ultrasonography which made possible the measurement of portal vein diameter (PVD) and the velocity of portal blood flow. The mean weights, blood pressure profiles and ultrasonographic splenic span and common bile duct diameters (BDD) did not differ significantly among the three groups. Similarly, the man PVDs of the three groups were not significantly different despite the large livers of the CH group. The CH group however showed linear growth faltering, a significantly lower mean haematocrit, faster pulse rate but paradoxically reduced hepatic portal blood flow velocity than HbA controls. Because of the disproportion of PVD relative to liver size in HbS patients with CH and the reduced portal blood flow velocity, hepatic perfusion is probably poorer in these patients. HbS children with CH therefore need careful management of hepatic and anaemic crises to prevent severe hypoxic liver damage.
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