Anesthesia for a jehovah’s witness with critical anemia from ruptured stomach GIST.

We report a case of a female Jehovah’s Witness admitted to the hospital with concealed rupture of stomach gastrointestinal stromal tumor (GIST) and scheduled for exploratory laparotomy with tumor removal. She was critically anemic and refused to receive all kinds of blood or blood products. We present anesthesia techniques to avoid blood transfusion in this patient, which include deliberate hypotension and acute normovolemic hemodilution.