Limits...
Transfusion free radical antegrade modular pancreaticosplenectomy of metastatic neuroendocrine tumor of the pancreas in Jehovah's Witness patient.

Jeon YB, Yun S, Choi D - Ann Surg Treat Res (2015)

Bottom Line: We present a case of successful bloodless multimodality therapy, which was performed for a JW.Multimodality therapy is very important for optimal treatment of PNET.Along with intimate interdepartmental cooperation, careful patient selection and appropriate perioperative management could possibly enhance the surgical outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Soonchunhyang University College of Medicine, Cheonan, Korea.

ABSTRACT
In a popular sense, Jehovah's Witnesses (JW) have their creeds, one of which is refusal of blood transfusion. Such refusal may impinge on their proper management, especially in critical situations. We present a case of successful bloodless multimodality therapy, which was performed for a JW. The patient was a 49-year-old woman and JW who had general weakness 7 days before admission. She was diagnosed with a pancreatic neuroendocrine tumor (PNET) with hepatic metastases. Transcatheter arterial chemoembolization and Sandostatin LAR injection were performed, and then she was given a transfusion-free Radical antegrade modular pancreatosplenectomy sequentially. We gave recombinant human erythropoietin and iron hydroxide sucrose complex daily for five days after surgery. She was discharged at postoperative day 12 without any surgical complications. Multimodality therapy is very important for optimal treatment of PNET. Along with intimate interdepartmental cooperation, careful patient selection and appropriate perioperative management could possibly enhance the surgical outcome.

No MeSH data available.


Related in: MedlinePlus

Abdominal CT scan. (A, B) A huge well-capsulated tumor (indicated by the arrow) is located in pancreatic body and tail, highly enhanced by contrast material. (C-F) Multiple hepatic metastases were found in both lobes. Successful transarterial chemoembolization was done for multiple lesions in liver.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4325654&req=5

Figure 1: Abdominal CT scan. (A, B) A huge well-capsulated tumor (indicated by the arrow) is located in pancreatic body and tail, highly enhanced by contrast material. (C-F) Multiple hepatic metastases were found in both lobes. Successful transarterial chemoembolization was done for multiple lesions in liver.

Mentions: A 49-year-old female patient came to the outpatient clinic with complaint of general weakness, mild discomfort and heat sensation in the abdomen. Diagnosed with PNET with multiple liver metastases at another hospital, she was transferred to our clinic for bloodless surgery owing to the patient's religious faith. The patient's height was 152 cm and weight was 53.6 kg. She didn't have any other underlying medical diseases such as hypertension, diabetes, hepatitis, tuberculosis and so on. Physical exams revealed mildly distended abdomen and a non-tender palpable intraabdominal mass. The serum tumor markers including CEA, CA 19-9, and α-FP were within normal limits, whereas liver function test levels including total bilirubin (1.3 mg/dL), aspartate transaminase (58 U/L), and alanine transaminase (49 U/L) were slightly elevated. Radiological tools including abdominal-pelvic CT scan, biliary and pancreas dynamic MRI with contrast, PET/CT scan, and bone scan contributed to diagnosis and therapeutic plan. According to the results of radiological imaging studies, a huge well capsulated tumor (about 8-cm diameter on the longest distance) was located in the pancreatic body and tail, which was highly enhanced by the contrast material. Multiple hepatic metastases were found in both lobes (Fig. 1A, B).


Transfusion free radical antegrade modular pancreaticosplenectomy of metastatic neuroendocrine tumor of the pancreas in Jehovah's Witness patient.

Jeon YB, Yun S, Choi D - Ann Surg Treat Res (2015)

Abdominal CT scan. (A, B) A huge well-capsulated tumor (indicated by the arrow) is located in pancreatic body and tail, highly enhanced by contrast material. (C-F) Multiple hepatic metastases were found in both lobes. Successful transarterial chemoembolization was done for multiple lesions in liver.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325654&req=5

Figure 1: Abdominal CT scan. (A, B) A huge well-capsulated tumor (indicated by the arrow) is located in pancreatic body and tail, highly enhanced by contrast material. (C-F) Multiple hepatic metastases were found in both lobes. Successful transarterial chemoembolization was done for multiple lesions in liver.
Mentions: A 49-year-old female patient came to the outpatient clinic with complaint of general weakness, mild discomfort and heat sensation in the abdomen. Diagnosed with PNET with multiple liver metastases at another hospital, she was transferred to our clinic for bloodless surgery owing to the patient's religious faith. The patient's height was 152 cm and weight was 53.6 kg. She didn't have any other underlying medical diseases such as hypertension, diabetes, hepatitis, tuberculosis and so on. Physical exams revealed mildly distended abdomen and a non-tender palpable intraabdominal mass. The serum tumor markers including CEA, CA 19-9, and α-FP were within normal limits, whereas liver function test levels including total bilirubin (1.3 mg/dL), aspartate transaminase (58 U/L), and alanine transaminase (49 U/L) were slightly elevated. Radiological tools including abdominal-pelvic CT scan, biliary and pancreas dynamic MRI with contrast, PET/CT scan, and bone scan contributed to diagnosis and therapeutic plan. According to the results of radiological imaging studies, a huge well capsulated tumor (about 8-cm diameter on the longest distance) was located in the pancreatic body and tail, which was highly enhanced by the contrast material. Multiple hepatic metastases were found in both lobes (Fig. 1A, B).

Bottom Line: We present a case of successful bloodless multimodality therapy, which was performed for a JW.Multimodality therapy is very important for optimal treatment of PNET.Along with intimate interdepartmental cooperation, careful patient selection and appropriate perioperative management could possibly enhance the surgical outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Soonchunhyang University College of Medicine, Cheonan, Korea.

ABSTRACT
In a popular sense, Jehovah's Witnesses (JW) have their creeds, one of which is refusal of blood transfusion. Such refusal may impinge on their proper management, especially in critical situations. We present a case of successful bloodless multimodality therapy, which was performed for a JW. The patient was a 49-year-old woman and JW who had general weakness 7 days before admission. She was diagnosed with a pancreatic neuroendocrine tumor (PNET) with hepatic metastases. Transcatheter arterial chemoembolization and Sandostatin LAR injection were performed, and then she was given a transfusion-free Radical antegrade modular pancreatosplenectomy sequentially. We gave recombinant human erythropoietin and iron hydroxide sucrose complex daily for five days after surgery. She was discharged at postoperative day 12 without any surgical complications. Multimodality therapy is very important for optimal treatment of PNET. Along with intimate interdepartmental cooperation, careful patient selection and appropriate perioperative management could possibly enhance the surgical outcome.

No MeSH data available.


Related in: MedlinePlus