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 CT Pulmonary homorrhage

07/09 Chest CT

Case 2 Renal biopsy was arranged: RPGN with crescent formation, IgA deposition. Consistent with HSP. Final diagnosis: Henoch-Schonlein purpura

Case 3 陳 x 任 15 Y/O male PH: cystic fibrosis diagnosed on CC: Dry cough noted since 12 y/o and became productive since 13 y/o, acute exacerbation twice in recent 1/2 years CXR and Chest CT was arrnaged.

07/06 CXR

07/20 Chest CT Bronchiectasis picture

07/20 Chest CT

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

07/15 Pelvic MRI

Case 4 Laparotomy was arranged on 94/07 Final diagnosis: Duplication of uterus and Vagina, right side obstruction and hydrometrocolpous