Surgery on elderly women poses its own entire set of potential complications. For example, drug doses (particularly anesthesia) are extremely different. Additionally, her organs and skin were incredibly frail, making them prone to damage. In the end, despite these inherent risks, the surgery was successful.
In addition to the 94 year old patient, the pregnant patient posed even more difficult challenges. As you may expect, operating on a pregnant woman’s ovary is an incredibly risky endeavor. One wrong move can fatally affect the fetus; too much residual heat from the Bovie or an accidental incision could easily injure the baby. The patient’s pre-op MRI gives a beautiful picture of the girl fetus, where you can easily make out the outline of her body in her mom’s abdomen (pictured above). What made this case interesting was the peculiar nature of her estrogen-secreting tumor, which Dr. Heffernan removed and sent for a frozen section in pathology. Diagnosis required the opinions of over five different pathologists, but the unfortunate conclusion is that the tumor is likely malignant. This will affect the course of treatment, which Dr. Heffernan will soon set.
Overall, the week was incredibly interesting and successful. I cannot wait for dozens more to follow.
