Sequential gastric and ileal perforations, a rare presentation in a man with sickle cell anemia: A case report

Abstract

The inheritance of the sickle gene (hemoglobin S) and another abnormal hemoglobin gene is described as sickle cell disease, and the homozygous form of the disease is hemoglobin SS. In sickle cell disease, abdominal pain is a common symptom attributed to circulatory stasis and vascular occlusion, along with chest and musculoskeletal pain for which nonsteroidal anti-inflammatory drugs are often prescribed. This report presents the case of a 21-year-old man with sequential gastric and ileal perforations related to nonsteroidal anti-inflammatory drug usage. Gastrointestinal perforation should be considered as a differential diagnosis in patients who present with abdominal pain accompanied with symptoms such as peritonitis, shock, or sepsis. Furthermore, perforation may be sequential with perforation of the stomach followed by that of the ileum. The use of nonsteroidal anti-inflammatory drugs in patients with sickle cell disease requires further revaluation.