title: Strategic management of severe acute pancreatitis in the Jehovah's witness.
abstract: Haemorrhage can be a lethal complication of severe acute pancreatitis. Management includes identification and control of the source of bleeding and supportive therapy such as blood transfusion. Individuals who refuse transfusion on the grounds of religious belief can provide a further major challenge. The management in these individuals can be focused from the outset with a strategy that aims to avert anaemia and transfusion. This article reports a case of severe acute pancreatitis in a woman of the Jehovah's Witness faith. The episode was complicated by infected pancreatic necrosis requiring surgical intervention. Careful strategic planning is critical to the management of severe acute pancreatitis in patients of the Jehovah's Witness faith. In this case, acute pancreatitis complicated by infected necrosis was successfully managed by the use of preoperative erythropoietin, venesection using paediatric blood vials, meticulous intraoperative attention to haemostasis and the use of adjunctive intraoperative techniques such as argon diathermy.
authors.affiliation: Department of Surgery, Hepatobiliary Unit, Manchester Royal Infirmary, UK.
authors.forename: S
authors.initials: S
authors.lastname: Jamdar
authors.forename: A K
authors.initials: AK
authors.lastname: Siriwardena
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D000075202:Contraindications; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D033221:Jehovah's Witnesses; D019283:Pancreatitis, Acute Necrotizing / Q000601:surgery*; D012068:Religion and Medicine