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Ciro Paolillo

44 articles published Follow:

Abdomen

Goodbye nasogastric lavage!

A 84 yo woman arrives in ED in midnight coming from a nursing because of a reported episode of coffee ground vomiting. Respiratory rate, heart rate and blood pressure are normal, abdomen is not distended, hemoglobin level is 10 g/dl. On rectal examination you find normal stool. She takes warfarin. Can a nasogasric…

ByCiro Paolillo10 July 20120Comments

Chest

Chest X-Ray and aortic dissection

A 70 yo man come to the ED for restrosternal chest pain and shortness of breath during minimal activity in the last days. He is an ex smoker, with a history of hypertension. On physical examination the patient is not in distress, with a regular blood pressure and regular oximetry. ECG shows no evidence of…

ByCiro Paolillo28 June 20120Comments

Abdomen

Is CRP correlated to CT result in the evaluation of abdominal pain?

A 74 yo/man complained of diffuse abdominal pain. The pain was intermittent and accompained by vomiting. He has no history of abdominal pain or abdominal surgery. On examinations the patient presented non icteric, afebrile, not tachicardic. The abdomen was mildly distensed with midline tenderness. The US evidenced a normal aorta diameter. Abdominal…

ByCiro Paolillo10 May 20120Comments

Chest

How LR works. Why any test is unnecessary for a patient with very low-risk chest pain?

A 40 yo truck driver, presented in ED with substernal chest pain. He is healthy, no family history of CAD. Held for observation, serial ECG have not modified, not elevated troponin. Is an Exercise Treadmill Testing useful (ETT)? Or a Myocardial Perfusion Imaging (MPI) is better? The pretest probability of CAD in this…

ByCiro Paolillo1 May 20120Comments

Abdomen Ultrasound

Does Murphy’s sign and sonographic Murphy sign have the same clinical utility?

A 40 yo woman presented to the ED with upper quadrant pain since three hours after eating a tasty pizza. She is overweight, she presents feverish (38°C) her skin is nonicteric. The abdomen is soft, there is tenderness on the upper right quadrant, you perform a deep palpation in the subcostal area, and the patient…

ByCiro Paolillo15 April 20120Comments

Chest Ultrasound

Diagnosis of pneumonia. Is it the time for a combined imaging strategy?

A 80 yo man is brought from an assisted-living facility because of fever, productive cough, tachycardia and dyspnoea. He has a history of dementia and hypertension. He is cachectic, you hear ronchi on the left side. How should you approach this patient? In the Emergency department setting the pretest probability of pneumonia…

ByCiro Paolillo5 April 20120Comments

Abdomen

Bowel obstruction and physical examination

A 75 y/o man arrives in ED from a nursing. He complains abdominal pain. No fever, no jaundice, abdomen presents distended. Inspection shows a midline old scar, there is diffuse rigidity, increased bowel sounds and vomit on the sheets. Can history and clinical examination contribute to diagnosis of bowel obstruction? …

ByCiro Paolillo10 February 20120Comments

Skin and soft tissue Ultrasound

Soft tissue abscess: clinical plus ultrasound evaluation

Male 65 y/o, he complains pain and swelling in left groin, he has history of hypertension. He has not fever. Clinical examination shows swelling, skin is hot and eritematous. Is it an abscess, a cellulitis or something else? Conclusion To use ultrasound on eritematous and swelling skin is very helpful Abscesses presents…

ByCiro Paolillo8 January 20120Comments

Skin and soft tissue

Soft tissue abscess the clinical evaluation

Male 65 y/o, he complains pain and swelling in left groin, he has history of hypertension. He has not fever. Clinical examination shows swelling, skin is hot and eritematous. Is it an abscess, a cellulitis or something else? Conclusion Differentiating a soft tissue abscess from cellulitis is important because each disorder requires a different…

ByCiro Paolillo14 December 20110Comments

Abdomen

Acute appendicitis and signs

A 21 y/o man presents to the ED with pain in right low quadrant (RLQ) , anorexia, nausea and vomiting. His abdomen is soft, with a mild tenderness in RLQ, the psoas sign is positive. The pain is aggravate by cough. You perform kindly a rectal examination with pain. Are this signs useful for the…

ByCiro Paolillo1 December 20110Comments

The Emergency Physician

Ciro Paolillo

Goodbye nasogastric lavage!

Chest X-Ray and aortic dissection

Is CRP correlated to CT result in the evaluation of abdominal pain?

How LR works. Why any test is unnecessary for a patient with very low-risk chest pain?

Does Murphy’s sign and sonographic Murphy sign have the same clinical utility?

Diagnosis of pneumonia. Is it the time for a combined imaging strategy?

Bowel obstruction and physical examination

Soft tissue abscess: clinical plus ultrasound evaluation

Soft tissue abscess the clinical evaluation

Acute appendicitis and signs

Septic Arthritis

Septic Arthritis and Arthrocentesis

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