Medical Diagnoses in Grey's Anatomy: A Comprehensive Review of Medical Conditions in Season 13
- 3 days ago
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Updated: 2 days ago
Welcome back to Grey Sloan Memorial Hospital. If Season 12 was about rebuilding, Season 13 is about resilience in the face of extreme trauma. This season takes us out of the operating room and into prisons, airplanes, and burning buildings, presenting some of the most high-stakes medical improvisations in the show’s history.
From the fallout of Alex Karev’s assault on Dr. DeLuca to the heartbreaking decline of Maggie’s mother, the medicine this season is personal, gritty, and often incredibly rare. In this post, we break down the medical accuracy, illness progression, and treatments for every major case in Season 13. Let's scrub in.
Content ⁉️
Episode 1: Undo
Orbital Floor Fracture with Entrapment & Grade IV Hyphema
The season opens with a severe trauma case involving one of the hospital's own. Following a brutal assault, Dr. DeLuca presents with a zygomatic fracture and a broken nose. The most critical injury is an orbital floor fracture with entrapment, meaning the eye muscle is caught in the broken bone, paralyzing the eye. He also suffers from an "eight-ball" (Grade IV) hyphema, a collection of blood in the anterior chamber of the eye.
Treatment: Dr. Jackson Avery performs surgery to "pop" the trapped muscle out of the fracture and flush the blood from the eye to reduce dangerous intraocular pressure. The procedure is successful, saving DeLuca’s vision and career.
Other Diagnoses:
Fractured Septum: Required reduction.
Fractured Clavicle: Indicated by obvious deformity.
Aspiration: Due to bleeding posteriorly through the airway.
Episode 2: Catastrophe and the Cure
Appendicitis & Renal Artery Thrombosis
Zach, a pediatric patient six months post-renal transplant, initially presents with early appendicitis. Because he is on immunosuppressants, surgery carries high infection risks, so a conservative antibiotic approach is taken. However, the appendix ruptures, leading to sepsis. Complicating matters, the patient develops a renal artery thrombosis (blood clot) in the transplanted kidney.
Treatment: A surgical team including Dr. Grey and Dr. DeLuca removes the large clot. The kidney "pinks up," indicating restored blood flow, and the organ is saved.
Other Diagnoses:
Myasthenia without Thymoma: Treated via thymectomy.
Post-operative Incision Complication: Required wound therapy.
Brain Tumor: Described as the size of a cantaloupe.
Episode 3: I Ain't No Miracle Worker
Lazarus Syndrome
In a rare medical phenomenon, Georgia Fisher enters cardiac arrest after a car crash. Despite 42 minutes of CPR and defibrillation, she is declared dead. However, she subsequently experiences a spontaneous return of circulation, known as Lazarus Syndrome.
Treatment: The medical team investigates potential causes such as impaired venous return due to dynamic hyperinflation or electrolyte imbalance. A TEE confirms no cardiac abnormalities, and she wakes up with no neurological deficits—a true medical "miracle."
Other Diagnoses:
Ruptured Spleen & Hemothorax: Trauma from the crash.
Transient Myocardial Stunning: Temporary heart weakness.
Le Fort Fracture: Severe mid-facial fracture.
Episode 4: Falling Slowly
Ehlers-Danlos Syndrome (EDS)
Emma is a "frequent flyer" dismissed as an alcoholic due to symptoms like dehydration and "the spins." The diagnostic breakthrough comes when her arm dislocates, and she casually pops it back in. Dr. Karev connects her symptoms—easy bruising, joint hypermobility, and fainting—to Ehlers-Danlos Syndrome, a connective tissue disorder.
Traumatic Splenic Rupture & Aortic Dissection
Following a glider crash, Polly initially appears stable with a Grade 3 splenic injury. However, she deteriorates rapidly. It is discovered her spleen has ruptured and her aorta is dissecting. While the surgery saves her life, the aortic dissection compromises blood flow to the spinal cord at the L-4 vertebrae, resulting in permanent paraplegia.
Other Diagnoses:
Meningioma: Tumor requiring a 16-hour removal.
Beeturia: Red urine caused by eating beets, mimicking hematuria.
Dural Carotid Cavernous Fistula (DCCF): Abnormal artery-vein connection.
Episode 5: Both Sides Now
Heat Stroke leading to Acute Liver Failure / End-Stage Liver Disease
This episode highlights organ allocation ethics. "Granny June" has End-Stage Liver Disease and awaits a transplant. Meanwhile, Chelsea, a young woman, suffers heat stroke (temp 40.2°C) which triggers acute liver failure.
Treatment: Despite being asked, June refuses to give up her liver. However, a donor (Andy, a former astronaut with a cardiac myxoma) dies after surgery complications, and his liver is a match for Chelsea, saving her life.
Other Diagnoses:
Cardiac Myxoma: A massive 6.2cm tumor in the left atrium.
Emergency Hand De-gloving: Skin stripped from the hand.
V-fib/V-tach: Fatal rhythms experienced by the cardiac patient.
Episode 6: Roar
Advanced Pancreatic Cancer in Pregnancy
Veronica presents with a hand rash and weight loss at 16 weeks pregnant. Diagnosis reveals a mass on her pancreas. Standard neoadjuvant chemoradiation would kill the fetus.
Treatment: Veronica opts for a high-risk open Whipple procedure (pancreaticoduodenectomy) to remove the cancer while maintaining the pregnancy. She understands the cancer will likely return and kill her after the baby is born, but chooses the surgery to save the child.
Other Diagnoses:
Congenital Arteriovenous Malformation (AVM): Ruptured in a child trauma patient, leading to death.
Bladder Rupture: Successfully repaired.
Volvulus: Twisted bowel requiring surgery.
Episode 7: Why Try to Change Me Now
Left Main Coronary Artery Occlusion
Enid comes in for a gallbladder issue, but pre-op checks reveal her left main coronary artery is nearly occluded. She requires an Emergent Coronary Artery Bypass Graft (CABG).
Treatment: Dr. Pierce performs the high-risk surgery. It becomes a teaching moment where Dr. DeLuca successfully clips a nicked internal mammary artery, saving the patient from bleeding out.
Other Diagnoses:
Liver Laceration: Fear in a trauma patient.
Air under the diaphragm: Indicates bowel perforation/injury.
Aortic Stenosis: Narrowing of the valve.
Episode 8: The Room Where It Happens
Grade IV Liver Laceration & Idiopathic Thrombocytopenic Purpura (ITP)
A trauma patient presents with a destroyed liver and uncontrollable bleeding. Resident Edwards diagnoses ITP, an autoimmune disease where the body attacks its own platelets, explaining why the bleeding won't stop.
Treatment: The team performs a total hepatectomy (removing the liver entirely) and creates a portacaval shunt while waiting for a transplant. Ultimately, they perform a "Hail Mary" partial liver autotransplant—repairing the liver outside the body before re-implanting it.
Other Diagnoses:
Ruptured AAA: Abdominal Aortic Aneurysm.
Disseminated Intravascular Coagulation (DIC): Ruled out in favor of ITP.
Multiple Myeloma: Differential diagnosis for another patient.
Episode 9: You Haven't Done Nothin'
Right-sided Hemothorax & Diaphragmatic Tear
A building collapse floods the ER. Winnie, a 12-year-old, suffers a right-sided hemothorax and exsanguinates due to a pulmonary artery bleed that cannot be sutured. Another patient, Charlie, survives a gastric injury and diaphragmatic tear.
Other Diagnoses:
Depressed Skull Fracture: Bone pushed inward toward the brain.
Splenic Laceration: Required exploratory laparotomy.
V-fib: Occurred during Winnie's surgery.
Episode 10: You Can Look (But You'd Better Not Touch)
TRAPS Syndrome (Twin Reversed Arterial Perfusion) / Acardiac Twin
Kristen, a pregnant inmate, has TRAPS syndrome. One twin is an acardiac twin (a parasitic mass) forcing the healthy baby's heart to work double-time.
Treatment: Drs. Robbins, Bailey, and Wilson perform a minimally invasive laser ablation in the prison infirmary to cut the blood supply to the mass. Kristen delivers a healthy baby girl shortly after.
Other Diagnoses:
Eyelid Laceration: Result of a prison fight.
Human Bite: High infection risk injury.
Episode 11: Jukebox Hero
Pelvic Fracture / Congenital Diaphragmatic Hernia (CDH)
Mindy, in active labor, is in a car crash. She suffers a pelvic fracture trapping the baby and a common iliac artery bleed. The baby is born with CDH (organs in the chest cavity).
Treatment: An emergency C-section is performed. The baby is placed on ECMO and undergoes hernia repair in the trauma bay, while Mindy undergoes vascular and orthopedic repair. Both survive.
Other Diagnoses:
Neuroblastoma: Tumor of nerve tissue.
Full facial deglovement: Severe soft tissue injury.
Pneumothorax: Collapsed lung.
Episode 12: None of Your Business
Hypothermia & Vascular Damage
Annie is found tangled in razor wire. She presents with hypothermia (core temp 32°C) and the wire has disrupted her popliteal artery.
Treatment: Due to the severity of the vascular damage and setting in of gangrene, the leg is amputated below the knee.
Inflammatory Breast Cancer (IBC)
Discovered during a consult for plastic surgery, Maggie’s mom is diagnosed with IBC, an aggressive cancer presenting as skin redness rather than a lump.
Other Diagnoses:
Intraperitoneal Bladder Rupture: Requires surgical repair.
Gallstones: Suspected despite clear CT.
Episode 13: It Only Gets Much Worse
Esophageal Cancer
Lynne undergoes surgery to remove an esophageal tumor. Post-op, she develops gastric fluid in the lungs because the esophageal stump perforates into the chest. A revision surgery successfully excises the tumor and repairs the leak.
Acute Cholecystitis & SMA Injury
A 9-year-old presents with rare pediatric gallstones. During the Lap-Chole, the trocar nicks the Superior Mesenteric Artery (SMA). Despite converting to an open surgery, the bleeding cannot be controlled, and the patient dies.
Other Diagnoses:
Colectomy: Colon removal.
Myocardial Infarction: Heart attack ruled out.
Episode 14: Back Where You Belong
Chronic Renal Failure
Chris needs a kidney. His mother donates, but during surgery, her remaining kidney develops stenosis, dissects, and thromboses. She is left with no kidneys. Chris is saved by a directed donation from his abusive father.
Schizophrenia & Pacemaker issues
A "Jane Doe" with disorganized speech has a "Ford Pinto" of a pacemaker. Doctors identify her via the device's serial number. She is diagnosed with schizophrenia and stabilized on haloperidol.
Other Diagnoses:
Malignant Hypertension: Rapid blood pressure rise during surgery.
ACL Injury: Delayed due to pregnancy.
Episode 15: Civil War
Hypoplastic Left Heart Syndrome (HLHS)
A neonate presents with HLHS, an underdeveloped left heart. Options are the Norwood procedure (3 staged surgeries) or a transplant. Due to mitral valve regurgitation, Dr. Riggs lists the baby for a transplant without consent, creating ethical friction. A heart is found, and the baby survives.
Other Diagnoses:
Full-Thickness Burns: From a propane explosion (turkey fryer).
Eviscerated Bowel: Traumatic abdominal injury.
Epidural Hematoma: Bleeding between skull and dura.
Episode 16: Who Is He (And What Is He To You)?
Laryngeal/Esophageal Tumor
Caroline has a massive tumor invading her throat. A transplant is ruled out. To save her voice (avoiding a laryngectomy), Dr. Avery performs a radical Autologous Intestinal Vocal Tube Reconstruction.
Treatment: Avery uses Caroline’s own intestine to create a valve and her appendix to create a vocal tube. She regains her voice.
Other Diagnoses:
Brain Death: Donor status.
Erosion and Bleeding: Complications from stents.
Episode 17: 'Till I Hear It From You
Loculated Acute on Chronic Subdural Hematoma
A 95-year-old surgeon falls while hiking. She has a brain bleed. Despite the high risk due to age and aspirin use, she opts for a craniotomy to have more time with her husband. She unfortunately dies during the procedure.
Other Diagnoses:
Syncope: Fainting episode.
Abdominal Aortic Aneurysm: Successfully treated.
Episode 18: Be Still, My Soul
Metastatic Breast Cancer
Diane’s cancer aggressively returns, metastasizing to the liver and causing obstruction. She undergoes stenting to lower her enzymes to qualify for a clinical trial (BXP protocol). However, the trial causes an esophageal tear and sepsis. Recognizing the futility and pain, Diane stops treatment and passes away.
Other Diagnoses:
Fibrosis: Scarring from radiation.
Sepsis: Infection complication.
Episode 19: What's Inside
Fetal Tumor
A massive teratoma compresses a fetus's heart. Dr. Robbins and Dr. Pierce perform open fetal surgery. They partially exteriorize the baby, perform a sternotomy, and remove the tumor.
Abdominal Tuberculosis
Intern Cross is dismissed as a hypochondriac but actually has Abdominal TB contracted in India. It mimics perforated diverticulitis until surgery reveals the infection.
Other Diagnoses:
Diverticulitis: Initial misdiagnosis.
Iodine Allergy: Prevented contrast CT.
Episode 20: In the Air Tonight
Epidural Hematoma (In Flight)
During severe turbulence, a passenger hits his head. Being on blood thinners, he develops an epidural hematoma.
Treatment: Dr. Grey performs a trephination (drilling into the skull) using a syringe needle, nail clippers, and a cocktail straw to drain the blood and relieve pressure, saving his life mid-flight.
Other Diagnoses:
Pulmonary Hypertension Crisis: A passenger suffocates at altitude; treated with Viagra (sildenafil) for vasodilation.
Wrist Injury: Sustained by flight attendant.
Episode 21: Don't Stop Me Now
Ascaris Lumbricoides (Roundworms)
A patient presents with abdominal pain and vomiting. A massive infestation of Ascaris lumbricoides is found. Surgery removes hundreds of worms, including a 10-inch "Big Mama."
Metastatic Cancer & Pulmonary Embolism
Veronica (from Ep 6) returns with spinal metastasis. She delivers via C-section but subsequently throws a pulmonary embolism. She refuses resuscitation (DNR) and passes away.
Other Diagnoses:
Bowel Obstruction: Initial suspicion for the worm case.
Valvuloplasty: Heart valve repair.
Episode 22: Leave It All Behind
Left Atrial Sarcoma
Holly has a giant, inoperable heart tumor. Dr. Pierce attempts a total removal, but the tumor has invaded the esophagus and posterior pericardium. It is unresectable. They debulk the tumor to buy her time, but cannot cure her.
Pituitary Adenoma / Apoplexy
A boy’s parents refuse surgery due to religious beliefs. He returns with apoplexy (bleeding into the tumor) causing blindness. Dr. Karev falsifies a seizure record to justify emergency surgery. The tumor is removed, and sight is restored.
Other Diagnoses:
Spleen Laceration: Treated with embolization.
Ischemia: Tissue blood restriction.
Episode 23: True Colors
Traumatic Aortic Injury & Grade 3 Liver Laceration
A car drives off a cliff. Alison has an aortic injury and a distended abdomen. It is revealed she drove off the cliff to stop Keith from raping her. Keith sustains a Grade 3 liver laceration and requires strict immobilization.
Other Diagnoses:
Hypoxic Brain Injury: Concern for a choking baby.
Esophageal Perforation: Treated with TPN.
Episode 24: Ring of Fire
Crush Injury & Compartment Syndrome
During a hospital fire, a child is trapped. Her leg is crushed, leading to cyanosis and cardiac arrest. Treatment: With the OR inaccessible, Dr. Edwards performs a limb salvage in the ER, using a shunt and graft to restore flow and save the leg.
Other Diagnoses:
Smoke Inhalation: Mass evacuation concern.
Kidney Stones: Painful condition during evacuation.
Severe Burns: Sustained by Dr. Edwards.
🔖 Key Takeaways
🗝️ High-Acuity Trauma: From building collapses to cliff divers, the trauma cases were visceral, often involving complex internal bleeding (hemothorax, liver lacerations).
🗝️ Rare Pathologies: The writers dug deep into medical textbooks this season, featuring "Zebra" diagnoses like Lazarus Syndrome, TRAPS syndrome, and Ascaris infestation.
🗝️ Interventional Creativity: Dr. Grey’s airplane trephination and Dr. Avery’s throat reconstruction highlight a theme of improvisational genius.
🗝️ Oncology Realism: The arc of Maggie’s mother provided a brutal, realistic look at the progression of inflammatory breast cancer and the complications of aggressive clinical trials.
Keywords: Grey's Anatomy Season 13
Grey's Anatomy Season 13
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