Acute illness often includes symptoms of RUQ pain, increasing jaundice, nausea, vomiting, dark urine, and lighter stools. An enlarging tender liver is often the main physical finding. See Hepatitis - Hepatic Sequestration . This complication is usually, but not invariably, associated with pain crisis. History may be signs or symptoms of precipitating infection, nausea and vomiting.
Physical exam shows rapidly enlarging tender liver with increasing jaundice.
Patient may be hypotensive. Bowel sounds are often present. Lab shows a rapid decrease in hemoglobin level over baseline. WBC, platelets and reticulocyte count are high. LDH, SGOT, direct and indirect bilirubin, alkaline phosphatase are markedly increased.