Title : Bloodless trans abdominal resection of a large pre sacral tumour in a jehovahs witness patient: A case report
Abstract:
Background: Presacral tumours are rare and surgically challenging lesions due to their deep pelvic location, proximity to major vessels, and risk of significant intraoperative haemorrhage. Surgical resection remains the mainstay of treatment. Jehovah’s Witness patients do not accept blood transfusion due to their religious beliefs, making the management of presacral tumours even more complicated.
Case Presentation: We report the case of a 67-year-old female Jehovah’s Witness who presented with a large presacral tumour. After preoperative optimization for 4 weeks using bloodless medicine and surgery principles, her preoperative haemoglobin increased from 11.9 to 13.9 g/dl. She subsequently underwent complete open trans-abdominal excision of a 13 cm presacral tumour without requiring blood transfusion despite significant blood loss of up to 2L.
Conclusion: This case demonstrates that large presacral tumours can be safely resected via a trans-abdominal approach in Jehovah’s Witness patients without the need for blood transfusion if the principles of bloodless medicine and surgery (BMS) are applied.
Keywords: Presacral tumour, Jehovah’s Witness, bloodless medicine and surgery
