The Case

            On December 23, 2008, a 69 year-old Caucasian female was admitted to the Royal University Hospital (RUH) in Saskatoon, SK. She presented with symptoms of severe upper abdominal pain, epigastric “burning” that radiated to her back, vomiting, and dyspnea. On investigation it was discovered that a gallstone had lodged in her ampulla of Vater causing an acute episode of pancreatitis. On Jan 8, 2009 she had a laparoscopic cholecystectomy to remove the gallstone. She was treated at RUH for acute pancreatitis from Dec 23, 2008 until Jan 15, 2009. On Jan 15, 2009, she was deemed stable enough to be transferred to a hospital near her hometown. However only eight days later, on Jan 22, 2009, she was brought back to RUH as she presented with jaundice, no appetite since Jan 18, no bowel movement for four days,  fatigue, and upper abdominal pain. She was diagnosed with and began treatment for obstructive jaundice. Since her readmission to RUH, malnourishment, nausea, vomiting, abdominal pain, and fatigue combined with multiple health issues, have complicated and prolonged her hospital stay.

 

Medical History

            This patient presented with a past medical history of Insulin Dependent Diabetes Mellitus (IDDM), also known as Type 1 Diabetes Mellitus, since age 14. The patient also presented with a history of atrial fibrillation, congestive heart failure, coronary artery disease, hypertension, stage 1 bronchoalveolar lung cancer (diagnosed in 2003), hypothyroidism, depression, gastroesophageal reflux disease (GERD), cholelithiasis (gallstones), increased blood lipids, and chemodectomas in her lungs. Previous to hospitalization, the patient was a smoker for over twenty years and she was independent in all of her activities of daily living, with the exception of driving. However, after being hospitalized for nearly three months, she is now a transfer of two with a walker and has developed extreme confusion and hallucinations indicating the need for further assessment into her deterioration.

Group Members: Tracey (Myra) Aranda, Tristan Cyca, Megan Eiswerth, Sheena Kohlert, Christa Koopman, Jana Simpson
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