It's good to be in the Children's Hospital! Interesting cases:
- VATS (a look inside the chest cavity) for unusual lung mass in child with possible ROHHAD - pretty much a syndrome where you get fat really quickly (and hypoventilation, hypothalamic issues)
- Gnathodiaphyseal dysplasia syndrome: Baby who came in with cartilaginous tumors of the jaw that made him look like he had 4 giant plums in his mouth. He was born with normal jaw, but in 6 months, developed these tumors. Other than being born with a femur fracture (bone fragility), nothing else really wrong. Apparently nobody really knows much about this syndrome, and once-in-a-life-time-case! Crazy stuff! Kind of looks like this, but even bigger!
After taking out the tumors, baby looked a lot more normal, but sadly, it's likely to recur.
- Bilious emesis (vomiting green stuff): volvulus
- Biliary atresia s/p (status post, aka after) liver transplant and failed Kasai procedure where they connect bile ducts with small intestine.
- Pyloric stenosis: I got to feel the "olive"! - nonbilious vomiting, hungry, s/p open pyloromyotomy
- Medulloblastoma, needed a portacath and gastrostomy for chemo
- MEN2A: Baby with constipation, go biopsy for Hirschprung's disease to look for aganglionic colon, but turns out there were hypertrophic ganglions. Pathologist recalled that being part of MEN2A syndrome, so endocrine surgeon did a thyroidectomy (supposed to be prophylactic against medullary carcinoma because rate of getting medullary cancer in MEN2A was 100%), and the baby already had cancer in their thyroid.
- VATS for a kid with lung nodules s/p chemoradiation for metastatic nasopharyngeal rhabdomyosarcoma (muscle cancer). Yikes!
- Enormous Wilm's tumor (10cm) + nephrectomy (taking out the kidney)
- Enormous bilateral ovarian serous cystadenoma
- Kid with heterotaxy polyspenia! (Article about it for those with access.) It's some insane congenital condition where there's malformation asymmetric organs: malrotation of the bowel, heart malformations, multiple small spleens, bilobed lungs, transverse liver, azygous continuation of the IVC...etc.
- Cleft palate fistula
- Gastroschisis (baby's bowel is coming out of a hole on the side of the umbilicus) + silo (to house the bowel to wait more room in belly to push bowel back in) + TPN 1mo
- LaForte I and III from ATV crash (wear helmets everyone!). Surgery to plate the fractures was insane! It was the first time I've seen someone get degloved (aka, scalped)! It was pretty much like you peel off everything from the skull. Picture examples for the non-queezy: degloving the face; degloving scalp.
- Nissen fundoplication (wrap part of stomach around esophagus to prevent reflux)
- Right lower lobectomy (via thoracotomy) for CCAM (congenital cystic adenomatoid mass)
- Handle bar injury: jejunal perforation
- Pectus Excavatum + Ravitch procedure (break cartilage, add metal bar) - Haller index 6.8
- I missed the duodenal atresia!!! So disappointed!! b/c of oral exam...darn. Apparently also had malro!
- Interesting conditions: Diamond Blackfan anemia
- Fontan (extracardiac) procedure for left hypoplastic heart syndrome (no left heart): IVC connected to pulmonary artery. Kid also had previous Norwood (RA to neo-aorta) and Glenn (SVC to PA).
- Sad cases: asphyxiation due to car window, drowning in home pool, 3yo ejected from car and massive head injuries, pronounced brain dead.
No comments:
Post a Comment