What should you know about splenic sequestration in sickle cell disease?

The spleen filters blood and supports immune function. During a sequestration episode, it suddenly enlarges as blood pools inside it instead of circulating normally. This can reduce oxygen delivery and may cause marked tiredness, weakness, dizziness, rapid breathing, a fast heartbeat, or pale skin. A child may have a swollen or painful abdomen on the upper left side. Splenic sequestration is a presentation of sickle cell disease, not proof that every abdominal symptom is caused by it.

A clinician may check the abdomen, pulse, breathing, blood pressure and blood count. A blood test can help show anaemia and guide urgent treatment, but it should not delay emergency assessment.

If someone with sickle cell disease may be having splenic sequestration, seek emergency medical care immediately. Keep them resting, do not leave them alone, and tell the clinical team about the sickle cell diagnosis, the change in symptoms and any prescribed medicines. Do not massage a swollen abdomen or rely on fluids and home observation. Treatment may include close monitoring, fluids, oxygen when needed, and a blood transfusion decided by the treating team.

Call emergency services for sudden abdominal swelling, severe weakness, fainting, confusion, breathing difficulty, unusual sleepiness, a very fast heartbeat, or skin that looks markedly pale. Urgent assessment is also needed when a person with sickle cell disease becomes much less active or appears suddenly unwell, even without obvious pain. Symptoms can worsen quickly, so do not wait for a routine appointment.

Ask how to recognise an enlarging spleen, which emergency number to use, whether your family should keep a written action plan, and how previous blood counts or transfusions affect future care.