title: Successful bowel surgery at hemoglobin 2 g/dL without blood transfusion.
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.
authors: Ramakrishnapillai Padmakumar, Madhukara Pai, Shams Farish, Department of General Surgery, Sunrise Hospital, Kakkanad, Kochi 682030, India.
authors: Ramakrishnapillai
authors: R
authors: Padmakumar
authors: Madhukara
authors: M
authors: Pai
authors: Shams
authors: S
authors: Farish
authors: Jayadevan
authors: J
authors: Rajeev
authors: Thampi
authors: T
authors: Sanjeev
authors: Thekke Veetil
authors: TV
authors: Sreevalsan
authors: Binu
authors: B
authors: Sheetal
authors: Yesudas Santhakumari
authors: YS
authors: Sooraj
authors: Shamna Safar
authors: SS
authors: Rowther
keywords: Enterotomy; Gastrointestinal bleed; Jehovah’s witnesses; Low hemoglobin level; Multiple terminal ileal ulceration; Right hemicolectomy.
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