Splenic infarction following air travel and associated with the sickling phenomenon.

Abstract

Cooley, Peterson, Engel, and Jernigan recently reported six cases in which the triad of splenic infarction, sicklemia trait, and high-altitude flying was found. Sullivan first reported a case of sickle cell trait in which there was evidence of intravascular sickling with resultant splenic infarction and multiple small thrombi elsewhere following an airplane flight. Other investigators have also considered the role of reduced oxygen tension associated with travel by air as a factor in precipitating sickle cell crises. Findlay and others found that the incidence of sickling seemed to be directly proportionate to the altitude and the duration of exposure to reduced oxygen tension. These studies were carried out under actual flight conditions to altitudes of 15,000 ft. On the other hand, Henderson and Thornell, in low pressure chamber studies of Negro aviation cadets with sicklemia, were unable to find intravascular sickling even at pressures simulating 10,000 ft. In one man