{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:00:33Z","timestamp":1790312433535,"version":"4.1.0"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>While colonic diverticulosis affects approximately half of adults over 60\u00a0years of age in Western populations, jejunal diverticulosis are rare with a reported prevalence of 0.2%\u20131.9% associated with high mortality rate (up to 40%) when presented as complicated. Performing lifesaving surgery while respecting patient\u2019s autonomy and informed refusal of blood transfusion represents a challenge on its own for the medical team. We present a case of a 74-year-old Jehovah\u2019s Witness man who was diagnosed intraoperatively with perforated jejunal diverticulitis. Emergency laparotomy with segmental jejunal resection and primary anastomosis was performed. On the fifth postoperative day the patient developed post-operative haemorrhage secondary to laparotomy disruption with omental tearing, requiring urgent reoperation. Despite refusing allogenic blood transfusion, blood loss was successfully managed without transfusion. Post-operative anemia was treated with intravenous iron, vitamin B12, Folic acid, and supportive care which resulted in gradual improvement. The patient was discharged on post-operative Day 11. This case highlights that successful management of perforated jejunal diverticulitis and post-operative haemorrhage is feasible in Jehovah\u2019s Witness patient through prompt surgical intervention, meticulous haemostasis, and bloodless postoperative anaemia treatment. To our knowledge, this is the first reported case of perforated jejunal diverticulitis in a Jehovah\u2019s Witness patient.<\/jats:p>","DOI":"10.1093\/jscr\/rjag822","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:20:42Z","timestamp":1789672842000},"source":"Crossref","is-referenced-by-count":0,"title":["Perforated jejunal diverticulitis in a Jehovah\u2019s Witness complicated by postoperative haemorrhage: a case report of successful bloodless management"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5286-3532","authenticated-orcid":false,"given":"Andrej","family":"Nikolovski","sequence":"first","affiliation":[{"name":"Department of Abdominal Surgery, Zan Mitrev Clinic , Bledski dogovor 8, 1000 Skopje ,","place":["North Macedonia"]},{"name":"Ss. Cyril and Methodius University in Skopje , 1000 Skopje ,","place":["North Macedonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaudia","family":"Gjinoska","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, Zan Mitrev Clinic , Bledski dogovor 8, 1000 Skopje ,","place":["North Macedonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3841-5266","authenticated-orcid":false,"given":"Shqipe","family":"Misimi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kavaja Hospital , 10510 Prishtina, Republic of Kosovo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil","family":"Stoicovski","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Zan Mitrev Clinic , Bledski dogovor 8, 1000 Skopje ,","place":["North Macedonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zan","family":"Mitrev","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Zan Mitrev Clinic , Bledski dogovor 8, 1000 Skopje ,","place":["North Macedonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"2026092500383328100_ref1","doi-asserted-by":"publisher","first-page":"152","DOI":"10.21037\/jovs.2018.07.01","article-title":"Therapeutic strategies for jejunal diverticulitis: our experience and a review of the recent literature","volume":"4","author":"Fleres","year":"2018","journal-title":"J Vis Surg"},{"key":"2026092500383328100_ref2","doi-asserted-by":"publisher","first-page":"100071","DOI":"10.1016\/j.sycrs.2024.100071","article-title":"Management of perforated jejunal diverticulitis: a case series and literature review","volume":"4","author":"Baumgartner","year":"2024","journal-title":"Surg Case Reports Adv Tech"},{"key":"2026092500383328100_ref3","doi-asserted-by":"publisher","first-page":"1413254","DOI":"10.3389\/fmed.2024.1413254","article-title":"Acute complicated jejunum diverticulitis: a case report with a short literature review","volume":"11","author":"Chiorescu","year":"2024","journal-title":"Front Med (Lausanne)"},{"key":"2026092500383328100_ref4","doi-asserted-by":"publisher","first-page":"rjad253","DOI":"10.1093\/jscr\/rjad253","article-title":"Strangulated diverticulum: a new acute complication of small bowel diverticulosis","volume":"2023","author":"Pajtak","year":"2023","journal-title":"J Surg Case Rep"},{"key":"2026092500383328100_ref5","doi-asserted-by":"publisher","first-page":"rjaf569","DOI":"10.1093\/jscr\/rjaf569","article-title":"Jejunal diverticulosis: complications and management - a case series","volume":"2025","author":"Betz","year":"2025","journal-title":"J Surg Case Rep"},{"key":"2026092500383328100_ref6","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1308\/rcsann.2016.0210","article-title":"Major abdominal surgery in Jehovah's witnesses","volume":"98","author":"Rollins","year":"2016","journal-title":"Ann R Coll Surg Engl"},{"key":"2026092500383328100_ref7","doi-asserted-by":"publisher","first-page":"6","DOI":"10.30579\/mbse.2022.5.1.6","author":"So","year":"2022"},{"key":"2026092500383328100_ref8","doi-asserted-by":"publisher","first-page":"33","DOI":"10.5114\/pg.2014.47496","article-title":"Surgery in Jehovah's witnesses - our experience","volume":"10","author":"Trzci\u0144ski","year":"2015","journal-title":"Prz Gastroenterol"},{"key":"2026092500383328100_ref9","doi-asserted-by":"publisher","author":"Piekarski","DOI":"10.1007\/s00101-025-01621-7"},{"key":"2026092500383328100_ref10","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1097\/eja.0000000000001803","article-title":"Management of severe peri-operative bleeding: guidelines from the European Society of Anaesthesiology and Intensive Care: second update 2022","volume":"40","author":"Kietaibl","year":"2023","journal-title":"Eur J Anaesthesiol"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/9\/rjag822\/71384535\/rjag822.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/9\/rjag822\/71384535\/rjag822.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:38:49Z","timestamp":1790311129000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag822\/8834144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":10,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,8,31]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag822","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,8,31]]},"article-number":"rjag822"}}