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Ruptured intrahepatic biliary intraductal papillary mucinous neoplasm in a Jehovah's Witness patient.

Intraductal papillary mucinous neoplasm (IPMN) of the bile duct is a rare lesion that is presented as dilated bile ducts filled with papillary or villous neoplastic biliary epithelium. Not infrequently, abundant mucin is produced by neoplastic cells and the bile ducts filled with mucin show tubular or cystic luminal dilatation. We report a patient who showed abdominal pain with a 5.53 2.5-cm sized biliary IPMN. The condition was treated by en bloc resection of ruptured cystic tumor with left lateral sectionectomy. It was a challenging surgery to us because the patient’s religious beliefs did not permit blood transfusion. However, a major hepatic surgery can be performed without blood transfusion sometimes, including such cases dealing with Jehovah’s Witness patients. To the best of our knowledge, this is the first report of a successful treatment for ruptured biliary IPMN without blood transfusion in a Jehovah’s Witness patient worldwide. Case Report