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Ciro Paolillo

44 articles published Follow:

Abdomen

Imaging strategies of suspected acute colonic diverticulitis: how does it work?

A 66 yo man complains of left lower quadrant (LLQ) pain, anoressia and fever, it is the first time. The pain is acute, there is not vomit, temperature is 38°C. Abdomen is treatable, with severe pain and tenderness localized at LLQ , there is not history of prior abdominal surgery. Probably this patient suffers of…

ByCiro Paolillo10 April 20130Comments

Abdomen Blood

Diagnosis of diverticulitis with hands and blood tests. Is it a good idea?

A 66 yo man complains of left lower quadrant (LLQ) abdominal pain from 4/5 hours. The pain is described as crampy initially, than continuous, there is not vomit. Temperature is 37.5°C. Abdomen is treatable, with moderate pain and tenderness localized at LLQ , there is not history of prior abdominal surgery. ED US excluded the…

ByCiro Paolillo7 March 20130Comments

Blood

Is CRP useful alone to support the hypotesis of a bacteremia?

I t’s a very cold February, but ED is very hot in every sense of the word. A 22 y/o student refers stomach pain, chills, fever and diffuse muscolar pain. He has fever (38° C) there is a mild diffuse abdominal pain. The CRP value is 30 mg/L. Are there flu symptoms,…

ByCiro Paolillo25 February 20130Comments

Chest Ultrasound

Is chest X ray necessary to rule out PNX after thoracic maneuvers?

I t’s a busy day in ED this morning. The first patient refers dyspnoea, he has an advanced pulmonary neoplasia, ultrasound and chest x-ray confirm that the left zone is occupated by a pleural effusion. The thoracentesis removes about 1.5 liter of fluid, the patient breathes easily. The second patient is 65 yo, he…

ByCiro Paolillo4 February 20130Comments

Bones and joints

Is it broken?

A nthony, a 15 y/o student, slipped and fell while playng soccer. The next morning he refers continue pain on the right elbow. “Is it broken?” ask Anthony and his father at the triage desktop? There is pain and edema near the elbow, no radial pulse deficit, he can fully extend and flex the articulation,…

ByCiro Paolillo7 January 20130Comments

Chest

Atypical or typical, is this the question?

I t is a busy day in your ED: A 60 y/o female refers a retrosternal pain radiates to right arm that lasts more than 20 minutes. A 50 y/o male refers a pressure in his chest, with tachycardia and sweating. A 75 y/o female refers a sharp and stabbing pain exacerbates by forceful breathing.…

ByCiro Paolillo8 December 20120Comments

Chest

Can we fight against Pulmonary Embolism using the LR’s arrows?

A 80 y/o woman presented to the ED for dyspnoea. She underwent a knee replacement 2 weeks ago, RR is 24, O2 saturation is 88%. HR is 90, the knee is edematous. You are going to hunt a pulmonary embolism (PE) While you phone the radiologist for a thorax CT scan you have an idea:…

ByCiro Paolillo31 October 20120Comments

Abdomen

Does procalcitonin have a role in the management of acute appendicitis?

A 18 yo man comes to the ED in the morning because of low abdominal pain, fever and nausea. At palpation there is mild pain in the right inferior quadrant, not guarding. Could procalcitonin (PTC) helps to exclude quickly an acute appendicitis? Conclusion The figures are clear. We cannot use the PCT to…

ByCiro Paolillo10 October 20120Comments

Bones and joints

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

A 40 yo lady arrives in ED by ambulance with neck and spinal immobilization because she fell down a staircare. The patient’s vital signs are within normal physiological parameters, she is alert, no deficit, remembers all, denies head contusion and neck pain. She complains for a sharp shoulder pain (NRS 10/10), it seems broken. If…

ByCiro Paolillo7 September 20120Comments

Skin and soft tissue

Cellulitis and the role of laboratory

A 72 y/o woman presented to the ED for swollen and painful leg. Physical examination shows an erythematous, tender and warm leg. Probably it is a cellulitis. In previous post we stressed the US use to increase diagnostic accuracy. Can WBC or CPR help in the differential diagnoses? Do they have a role…

ByCiro Paolillo10 August 20120Comments

The Emergency Physician

Ciro Paolillo

Imaging strategies of suspected acute colonic diverticulitis: how does it work?

Diagnosis of diverticulitis with hands and blood tests. Is it a good idea?

Is CRP useful alone to support the hypotesis of a bacteremia?

Is chest X ray necessary to rule out PNX after thoracic maneuvers?

Is it broken?

Atypical or typical, is this the question?

Can we fight against Pulmonary Embolism using the LR’s arrows?

Does procalcitonin have a role in the management of acute appendicitis?

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

Cellulitis and the role of laboratory

Septic Arthritis

Septic Arthritis and Arthrocentesis

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