Emergency subtotal colectomy in a Jehovah's Witness with massive lower gastrointestinal bleeding: challenges encountered and lessons learned.


Journal Article

A 66-year-old woman who was a Jehovah's Witness had massive lower gastrointestinal bleeding and subsequent hypovolemic shock, necessitating a subtotal colectomy. During the postoperative period, her hemoglobin level decreased to a low of 2.6 g/dL, prolonging her dependence on mechanical ventilation. Prudent perioperative care resulted in a successful outcome. Blood-conserving techniques are indispensable in the management of Jehovah's Witnesses who have massive blood loss. Maximizing oxygen transport, minimizing blood loss, using a cell saver when permissible, providing optimal ventilatory support, performing tracheostomy early if prolonged mechanical ventilation is expected, and augmenting hemoglobin production with administration of iron and erythropoietin are techniques that can facilitate successful outcome in patients who refuse blood transfusion.

Full Text

Cited Authors

  • Raman, SR; Parithivel, VS; Cosgrove, JM

Published Date

  • March 2011

Published In

Volume / Issue

  • 20 / 2

Start / End Page

  • 179 - 178

PubMed ID

  • 21362723

Pubmed Central ID

  • 21362723

Electronic International Standard Serial Number (EISSN)

  • 1937-710X

International Standard Serial Number (ISSN)

  • 1062-3264

Digital Object Identifier (DOI)

  • 10.4037/ajcc2011498


  • eng