### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My granddaughter who is 9 (Type 1 Diabetic) was recently admitted/discharged diagnosed with a kidney infection.  While ruling out appendicitius, they found evidence of an old legion (maybe from an enjury ? ) on her liver. Her liver emzymes were abnormal.  Yesterday me SIL went to the hospital and got results from a ultrasound.  They found that her spleen was enlarged, she has gallstones, some mention of sphreositosis (SP?) and her uterus is small. Diagnosis consistent with sicle cell anemia.  We do not know if her doctor is even aware of these reports yet.Could you please explain the meaning of the report?

### output:

Hi there, Im sorry your granddaughter is having some health issues. Let me explain each item in the report with the information you've provided me.  Phagocytosis are abnormal types of blood cells that are round instead of the usual disc shape. This can be quite common in patients with sickle cell anemia, as the body pushes out immature red blood cells due to the shortage of normal functioning blood cells. The spleen digests red blood cells that are normal, and in cases of sickle cell or other hematologic disease, can become enlarged due to the fact that it is working harder.  If your granddaughter is very anemic or having low platelets, sometimes a splenectomy (removal of the spleen is warranted). If she's not having any difficulty with anemia or bleeding, then leaving the spleen in is an option. When red blood cells get broken down at an increased rate, this can cause gallstones to form in the gallbladder, which can also cause liver enzymes to be elevated. I don't believe that her kidney infection or type 1 diabetes are related to her sickle cell anemia, but if she's having recurrent abdominal pain (sickle cell crisis) and gallstones, it may not be a bad idea to consider having her gallbladder and spleen removed at the same time. Finally, a small uterus is nothing to be concerned about in a 9-year-old. This sounds like an incidental finding.  I hope I have answered your questions. Please feel free to contact me should you have any further questions.