|
The patient was treated with surgical resection of ischemic
bowel on 8-18-03 when free air was found on abdominal films. Pathologic
review of the surgical material did not find evidence for active PAN.
The patient developed fevers on the second postoperative day and it was
thought that he had developed an anastomic leak in the bowel and sepsis.
He was given comfort measures and died on 8-21-03. An Autopsy was requested.
.jpg) |
CXR from 8-19-03 |
.jpg) |
CXR from 8-21-03 |
| CBC with Differential |
Name |
Result/Unit |
|
Ref Interval |
WHITE BLOOD CELL COUNT |
4.15 K/uL |
|
3.20-10.60 |
RED BLOOD CELL COUNT |
2.20 M/uL |
L |
4.69-6.07 |
HEMOGLOBIN |
7.9 g/dL |
L |
14.6-17.8 |
HEMATOCRIT |
22.5 % |
L |
40.8-51.9 |
MEAN CORPUSCULAR VOLUME |
102.4 fL |
H |
77.8-94.0 |
MEAN CORPUSCULAR HEMOGLOBIN |
36.1 pg |
H |
26.5-32.6 |
MEAN CORPUSCULAR HGB CONC |
35.2 g/dL |
|
32.7-36.9 |
RED CELL DISTRIBUTION WIDTH |
18.0 % |
H |
10.8-14.1 |
PLATELETS |
379 K/uL |
|
177-406 |
MEAN PLATELET VOLUME |
8.1 fL |
|
5.9-9.8 |
POLYMORPHONUCLEAR |
72 % |
|
44-76 |
BAND |
25 % |
H |
0-5 |
LYMPHOCYTE |
2 % |
L |
15-43 |
EOSINOPHIL |
1 % |
|
0-6 |
PLATELET ESTIMATE |
ADEQUATE |
|
NORMAL |
ANISOCYTOSIS |
2+ |
A |
|
POIKILOCYTOSIS |
1+ |
A |
|
MACROCYTOSIS |
1+ |
A |
|
POLYCHROMASIA |
1+ |
A |
|
SMEAR INTERPRETATION Comments:
PERIPHERAL BLOOD:
- NORMOCHROMIC, MACROCYTIC ANEMIA WITH MODERATE ANISOPOIKILOCYTOSIS.
- RELATIVE NEUTROPHILIA WITH SHIFT TO IMMATURITY IN MYELOID SERIES.
- ABSOLUTE LYMPHOPENIA.
1. What do these CBC findings have to do with his underlying vasculitis?
2. What changes are seen on CXR?
|
