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Ciro Paolillo

44 articles published Follow:

Head

Tongue biting and seizure

It’s a routine Wednesday morning in the ED. An ambulance carries a 25 year old male patient with loss of consciousness lasted for 2–4 min, giddiness, and dimness of vision. The patient had these symptoms while he was at home, alone. The patient reports that he probably regained from his loss of consciousness after few…

ByCiro Paolillo11 February 20220Comments

Abdomen

Blood test and urgent abdominal conditions

A 44 YO man presents to the ED complaining of abdominal pain. He was well until 4 hours ago, when he developed diffuse abdominal pain. This is the first time he suffers abdominal pain. He has not history of surgery. The patient is afebrile, HR is 80, BP is 180/100, ECG is normal. The abdomen…

ByCiro Paolillo1 January 20160Comments

Abdomen

Where is peritonitis?

A 80 YO man with a history of hypertension presents to the ED complaining of abdominal pain. He felt well until 8 hours ago, when he developed diffuse abdominal pain. The patient is afebrile, tachicardic, BP is 180/100 his lungs are clear, ECG shows no changes suggestive of ischemia. There is diffuse abdominal rigidity. In…

ByCiro Paolillo27 April 20150Comments

Abdomen

Run to the operation room!

A 70 yo woman is brought to the ED by ambulance. She’s suffering from vomit, lach of flatus and abdominal pain since 24 hours says the nurse. She’s pale, the abdomen shows a midline scar. There is diffused tenderness with rebound. Abdomen US and X rays show abnormal distended loop of small bowel. Ok,…

ByCiro Paolillo19 January 20150Comments

News

My heart hates Christmas

It’s 7 pm on Christmas day, a 32 yo woman refers palpitations since the morning. I was with my frends yesterday nigth, I think I had drank a bit too much. I Hate Christmas, it brings me down. She’s awake, alert and oriented, her mood is low. Vital signs are normal, EKG shows a sinus…

ByCiro Paolillo25 December 20140Comments

Blood

NO fever, NO bacteriaemia?

A 80 yo nursing home resident woman is brought to the ED by ambulance. “Hypothension, cough and a hystory of heart failure ”, refers the nurse. She looks pale and confused, her respiratory rate is 22, oxygen saturation on room air is 90%. Ear temperature is 36,5°C, BP is 90/60 mmHg, HR is…

ByCiro Paolillo24 October 20140Comments

Bones and joints

Diagnosis of scaphoid fractures. Are plain radiographs reliable?

It's a busy wednesday morning in ED. A 18 yo guy presents with the right hand upraised and dressed. In the other hand he has a bundle of X ray. “About ten days ago, it was a Saturday night, I was with my new girl-friend. Hitting a punch bag as hard as…

ByCiro Paolillo6 August 20140Comments

Bones and joints

Is my hand broken?

A 24 y/o guy presents in ED with the left hand upraised. “I fell off my bike yesterday – he says – I remember a serious impact with an outstreched palm.” There aren’t wounds, he feels pain on the radial side of left wrist, there is an anatomical snuffbox tenderness. The clamp sign is…

ByCiro Paolillo16 June 20140Comments

Bones and joints

Ottawa ankle rules. Does it really work?

A 16 yo guy is brought in ED by his mother after a scholar accident. While he was running, he crashed. My son has a sore ankle! Is it broken? Asks the mother seriously worried. The ankle his slightly tumefied, there isn’t bone tenderness at the posterior edge or tips of either malleolus,…

ByCiro Paolillo11 April 20140Comments

Abdomen

Alarm symptoms and gastric cancer. Are they alarms or they are alarming?

It’s a busy Monday morning in ED. A doctor at the phone – calls the nurse – there’s a primary care physician. Hi – says a voice on the other side – I’m in a patient’s home. He’s a 40 yo man with dyspepsia, his wife refers weight loss of about 10…

ByCiro Paolillo24 January 20140Comments

The Emergency Physician

Ciro Paolillo

Tongue biting and seizure

Blood test and urgent abdominal conditions

Where is peritonitis?

Run to the operation room!

My heart hates Christmas

NO fever, NO bacteriaemia?

Diagnosis of scaphoid fractures. Are plain radiographs reliable?

Is my hand broken?

Ottawa ankle rules. Does it really work?

Alarm symptoms and gastric cancer. Are they alarms or they are alarming?

Septic Arthritis

Septic Arthritis and Arthrocentesis

Is cervical spine X-ray necessary if there is a distracting injury?