Case Study, Pediatric Services

Case study: Reversing Fontan-related liver disease in a preteen

The patient A 12-year-old boy born with double-inlet left ventricle (DILV), mitral stenosis, left-sided superior vena cava coronary sinus and pulmonary stenosis: The patient had been through surgical palliation as a baby, leaving him with Fontan circulation. The challenge Over the past decade we’ve learned that single-ventricle Fontan circulation has significant impacts on the heart…

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Case Study, Diabetes, Pediatric Services

Diabetes mellitus case study: Yo-yo glucose in active teen

The patient A teenage male with Type 1 diabetes mellitus, who is very active in sports and physical activity: He was having extreme difficulty with blood glucose control. The challenge Patient’s blood glucose levels often were high before activity. Lows would occur during activity or after. Treatment of lows often would cause a rebound high…

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Adult Services, Case Study, Neuro-Oncology

Case study: Awake brain tumor resection helps preserve healthy tissue

The patient A 39-year-old nursing student initially presented with complaints of a two-year history of intermittent numbness in the tips of the middle and ring finger on her left hand. Over the past six months, she developed episodic numbness in the left face and twitching in the left eye. An MRI scan demonstrated a brain…

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Case Study, Pediatric Services

Case Study: Uncovering a hidden case of pediatric septic arthritis

The patient A 14-month-old female presented to the emergency department with fever and refusal to bear weight. She had bilateral ear tube insertion 13 days previously and presented to her primary care provider (PCP) three days prior for a viral respiratory infection. She presented to her PCP the day before her admission for refusal to…

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Case Study, Pediatric Services

Case study: MIS-C patient with complications seeks return to sports

The patient A young adolescent male who participates in competitive football and basketball and with history of recent COVID-19 infection was admitted to the pediatric intensive care unit at Norton Children’s Hospital. The initial workup was consistent with multisystem inflammatory syndrome in children (MIS-C), and clinical presentation was consistent with severe MIS-C with respiratory, liver…

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Adult Services, Case Study, Neuroscience

MS case study: Specialized care allows for early therapy that resolves symptoms in months

The patient A 29-year-old woman with no major medical issues awoke with blurry vision. As the day went on, she began to see double. She looked in the mirror and saw that one of her eyes was pointing in the wrong direction. She also noted tingling across her body and severe fatigue. An immediate evaluation…

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Adult Services, Cardiovascular, Case Study

Hybrid ablation case study: Left ventricular function normalized, medication reduced

The patient A woman presented to Norton Audubon Hospital with shortness of breath and dizziness and was noted to be in new-onset atrial fibrillation (A-fib). She underwent immediate cardioversion but had recurrent A-fib and then was placed on flecainide with a repeat successful cardioversion. Her echocardiogram showed normal left ventricular function. The providers Kent E….

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Case Study, Pediatric Services

Pediatric oncology case study: Rotationplasty aids osteosarcoma recovery

The patient A 12-year-old female presented to Norton Children’s Hospital emergency department with a one-week history of worsening right knee pain and swelling. There was no known trauma, but pain started after exertion in gym class. Initial MRI demonstrated an aggressive bone lesion involving almost the entire right femur. She underwent initial biopsy which confirmed…

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Adult Services, Case Study, Oncology/Hematology, Orthopedics

Pelvis osteosarcoma study: A complex biplane osteotomy maintains pelvic ring continuity

The patient A 31-year-old otherwise healthy man presented with an enlarging and increasingly symptomatic left posterior ilium tumor. Biopsy revealed high grade osteosarcoma. Additional staging studies demonstrated no distant metastases. He was treated with neoadjuvant MAP chemotherapy (methotrexate, Adriamycin, cisplatin). The challenge Pelvis osteosarcomas have lower overall survival than those of the extremities. Positive surgical…

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Case Study, Pediatric Services

Pediatric heart case study: Piccolo device closes PDA in 26 weeks’ gestation neonate

The patient A girl born at 26 weeks’ gestation due to premature labor and prolonged premature rupture of membranes. At birth she weighing 891 grams. The mother received appropriate dose of steroids prior to giving birth, and the baby was intubated shortly after birth) and given surfactant with a second dose given at 12 hours….

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Adult Services, Case Study, Neuroscience

Stroke Summary: Mechanical thrombectomy helps marathoner, 47, recover from stroke

The patient presented to the emergency department at Norton Audubon Hospital. He had been found at home, down in the bathroom. Incident details: May 3, 2021 47-year-old male arrived at Norton Audubon Hospital, 12:27 a.m. Norton Neuroscience Institute physicians: Vascular neurologist Mohammad S. Alsorogi, M.D. Endovascular neurosurgeon Tom L. Yao, M.D. Presenting complaint The patient…

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Adult Services, Case Study, Neuro-Oncology

Brain tumor study: Using Gleolan fluorescent marker to reveal diffusely infiltrative glioma tumor

The patient A 57-year-old man presented to the Norton Brownsboro Hospital emergency department with complaints of headaches that started two weeks earlier and worsened over the preceding few days. In addition, his family reported subtle changes in behavior, including increased sleepiness and issues with memory. A magnetic resonance imaging (MRI) scan demonstrated a brain mass…

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