An unusual development

      A 28-year-old man with sickle cell disease was admitted with chief complaints of jaundice, abdominal distension, constipation, and back and hip pain characteristic of prior sickle cell flares. For 2 weeks prior to admission, the patient had tried unsuccessfully to control his pain with a home narcotic regimen. He denied fevers, chills, chest pain, and shortness of breath, but he did report abdominal distension and constipation that coincided with his increased use of narcotics.
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