Temporary partial intra-iliac balloon occlusion for the treatment of acetabulum fracture in a Jehovah's Witness: a case report.
Blunt trauma patients with acetabular fractures can lose as much as 2 L of blood after injury, and approximately 40% of these patients require blood transfusions. Fractures involving the anterior and posterior columns may require more than 1 surgery for adequate fracture fixation, increasing the potential for greater blood loss. Although blood transfusions may be medically necessary in these cases, Jehovah's Witnesses often refuse transfusion as a matter of religious conviction. The religious tenets of this faith preclude the use of blood transfusions and certain other blood products, based on an interpretation of Acts 15:29. To treat patients with these beliefs, various techniques have been developed to minimize blood loss as an alternative to transfusion. Temporary arterial balloon occlusion, also known as an "internal tourniquet," was first reported in 1954 for use in severe penetrating abdominal trauma. It was later used to control basilar artery bleeding and to limit blood loss in Jehovah's Witness patients undergoing revision total hip or knee arthroplasty. This case report documents the successful use of temporary balloon occlusion to minimize blood loss during an open reduction internal fixation of a both-column acetabulum fracture in a Jehovah's Witness patient. The method used for achieving this intra-iliac balloon occlusion is described in detail so that others also may implement this technique.
DiPasquale
T
T
Department of Orthopaedic Trauma, Florida Orthopaedic Institute, USA.
Greiwe
R Michael
RM
Simmons
Patti
P
Zweibel
Bruce
B
Bernasek
Thomas
T
Steinberg
James
J
Mangar
Devnand
D
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries*; D021721:Balloon Occlusion; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007083:Iliac Artery; D033221:Jehovah's Witnesses; D008297:Male; D008875:Middle Aged; D011859:Radiography