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. 2013 Aug 27;5(8):252-5.
doi: 10.4240/wjgs.v5.i8.252.

Successful bowel surgery at hemoglobin 2 g/dL without blood transfusion

Ramakrishnapillai Padmakumar  1 , Madhukara Pai, Shams Farish, Jayadevan Rajeev, Thampi Sanjeev, Thekke Veetil Sreevalsan, Binu Sheetal, Yesudas Santhakumari Sooraj, Shamna Safar Rowther
Affiliations

Successful bowel surgery at hemoglobin 2 g/dL without blood transfusion

Ramakrishnapillai Padmakumar et al. World J Gastrointest Surg. .

Abstract

We were unable to find reports in the published medical literature of any cases of bowel surgery being successfully performed at such a low hemoglobin level, without blood transfusion or blood products pre or post-surgery, with the patient's uncomplicated recovery. This study is about such a case. A patient presenting with severe gastrointestinal bleeding was diagnosed with enteric fever and multiple ileal ulcers. He had an extremely low hemoglobin level (2 g/dL) and mild renal and hepatic impairment. He was immediately admitted for right hemicolectomy under general anesthesia though he refused transfusion of blood or blood products prior to, during, or after surgery on religious grounds (Jehovah's Witnesses). After the surgery and having survived these potentially life-threatening circumstances, he left the hospital without major complications. In such circumstances, lives may be saved by prompt clinical decision-making, collaboration and swift surgical intervention coupled with the immediate consultation and input of the patient and family.

Keywords: Enterotomy; Gastrointestinal bleed; Jehovah’s witnesses; Low hemoglobin level; Multiple terminal ileal ulceration; Right hemicolectomy..

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Figures

Figure 1
Figure 1
Improvement of hemoglobin during the course of treatment.
See this image and copyright information in PMC

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