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Final Anatomical Diagnosis B9402036 陳佑丞 B9402031 陳奕廷.

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Presentation on theme: "Final Anatomical Diagnosis B9402036 陳佑丞 B9402031 陳奕廷."— Presentation transcript:

1 Final Anatomical Diagnosis B 陳佑丞 B 陳奕廷

2 (1) Pulmonary edema (2) Pleural effusion (3) Aspiration pneumonia (4) Focal angioinvasive aspergillosis (5) Tracheal ulcer (6) Epicardial hemorrhage (7) Atherosclerosis

3 (1) Pulmonary edema 定義 : 肺泡聚積組織液 原因 : 1.Hydrostatic pressure↑ -Mitral regurgitation (MR) -Left heart failure 2.Capillary permeability↑ -pneumonia -septicemia

4 (1) Pulmonary edema History(1): 第一次看診時檢查就有 mild MR  Left heart failure  Pulmonary congestion  Pulmonary edema

5 (1) Pulmonary edema History(2): While unclamping, sudden cardiac arrest  給予 Bosmin  H.R. resumed, but PCWP↑  pulmonary edema

6 (1) Pulmonary edema History(3): 病人主訴自從 83 年 9 月開始就有 nausea, vomiting 等症狀  aspiration pneumonia  pulmonary vascular permeability↑  pulmonary edema

7 (1) Pulmonary edema History(4): Acute pancreatitis  septicemia  pulmonary vascular permeability↑  pulmonary edema

8 (2) Pleural effusion 定義 : 組織液滲出至肋膜腔 原因 : 1.Hydrostatic pressure↑ -Mitral regurgitation (MR) -Left heart failure 2.Capillary permeability↑ -pneumonia -septicemia

9 (2) Pleural effusion History: MR, PCWP↑, aspiration pneumonia, septicemia  Pleural effusion

10 (3) Aspiration pneumonia 定義 : 因吸入嘔吐物 ( 含胃酸 ) 所造成的肺炎, 通常發生在意識不清者, 好犯右肺, 在 CXR 呈現 patch( 一片白 ) 成因 : 胃酸 + 混合性感染 (S. aureus + Gram(-) bacilli)  bronchial (lobular) pneumonia

11 (3) Aspiration pneumonia History(1): 病人主訴自從 83 年 9 月開始就有 nausea, vomiting 等症狀  aspiration pneumonia

12 (3) Aspiration pneumonia History(2): 手術過程中, 病患處於意識不清狀態, 容易吸 入自己嘔吐物  aspiration pneumonia

13 (3) Aspiration pneumonia History(3): 【 】術後胸部 X 光顯示 right pleural effusion with possible pneumonic patch on right lung field

14 (4)Focal angioinvasive aspergillosis 定義 : 由 Aspergillus 感染造成, 常發生在免疫 抑制的人, 會造成 angioinvasion Pathology: -Septated, branching fungal hyphae -Fungus ball

15 (4)Focal angioinvasive aspergillosis History(1): 術後使用免疫抑制劑 : cyclosporine, steroid, imuran  immunity↓  aspergillosis with angioinvasion


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