94 年 7月小兒科 X-Ray Conference (07/25)報告者 : 兒科 丁瑋信 /放射科 施君鏻醫師

Case 1• 廖 x 博 6 Y/O Male• CC: abdominal pain since 2 days ago (maily RLQ and

lower abdomen) • PH: Suspect Appendicitis under antibiotics treatment

94/03/10~94/03/15

• PE revealed tenderness over RLQ with muscle guarding and rebounding pain. Therefore, plain abdomen and abdominal CT was arranged

07/07 Plain

abdomen

07/09 Abd. CT

07/09 Abd. CT Pus accumulation

Case 2• 王 x云 9 Y/O female• CC: coca cola-colored urine was noted today • PH:

She was found pale looking and occasional cough with blood-tinged sputum (hemoptysis) since 6 months ago.

Survey at other hospital showed normocytic anemia.

• Urinalysis: RBC: Numerous/HPF WBC: 65/HPF

Case 2• Pulmonary renal syndrome was suspected

D/D: microscopic polyangiitis, HSP • Autoimmune survey:C3: 129 MG/DL; C4: 30 MG/DL; (WNL)

Antinuclear Factor: 160+, Anti-ds DNA: negative

IGA: 198 MG/DL; (WNL)

Perinuclear ANCA: Positive

Cytoplasmic ANCA: negative

• CXR and Chest CT was arrnaged.

07/07 CXR

Pulmonary hemorrhage

07/09 Chest CTPulmonary homorrhage

07/09 Chest CT

07/09 Chest CT

Case 2• Renal biopsy was arranged: RPGN with crescent for

mation, IgA deposition. Consistent with HSP.

• Final diagnosis: Henoch-Schonlein purpura

Case 3• 陳 x任 15 Y/O male• PH: cystic fibrosis diagnosed on 2004-12 • CC: Dry cough noted since 12 y/o and became productive sinc

e 13 y/o, acute exacerbation twice in recent 1/2 years

• CXR and Chest CT was arrnaged.

07/06 CXR

07/20 Chest CTBronchiectasis picture

07/20 Chest CTBronchiectasis picture

07/20 Chest CT

Case 4• 邱 x華 11 Y/O female• CC: Intermittent abdominal pain over RLQ and infrau

mbilical area at interval of 1 month since 6 months ago

• Abdominal echo:

1. a multilocular cystic mass (12*11*10cm) in pelvis

2. solitary hypertrphic L't kidney with R't kidney agenesis

• Pelvic MRI was arranged for her

07/15Pelvic MRI

07/15Pelvic MRI

07/15Pelvic MRI

07/15Pelvic MRI

07/15Pelvic MRI

Case 4• Laparotomy was arranged on 94/07

• Final diagnosis: Duplication of uterus and Vagina, right side obstruction and hydrometrocolpous