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

Is it a subtle appendicitis? How to make time your friend (part two)

It’s about the end of the night shift, in Observation Unit there’s George a 25 yo male presented the evening before with a mild periumbilical pain since 2 days than localized to the right lower quadrant. He was afebrile with stable vital signs, in the car, arriving to the ED, there was vomit, not diahrrea.…

ByCiro Paolillo11 September 20130Comments

Abdomen

Is it a subtle appendicitis? How to make time your friend

Mr. Smith is a 39 yo man with abdominal pain. He has been visited, few hours ago, by his primary care doctor who sent him to you for a surgeon consult. He refers abdominal pain, fever and nausea since the day before. The pain was previously in the midabdomen, than it migrated to the right…

ByCiro Paolillo11 August 20130Comments

Abdomen

How have you come to the hospital?

It’s just started your night shift, Sara is a young EP, she is going home after an hard day. Hello - she says tired - could you help me? There is a guy with abdominal pain and nausea. I think it could be appendicitis, but there is not fever and not leukocytosis. Have you asked…

ByCiro Paolillo22 April 20130Comments

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

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

Abdomen

Acute appendicitis and Symptoms

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 Paolillo21 October 20110Comments

Blood test and urgent abdominal conditions

Is it a subtle appendicitis? How to make time your friend (part two)

Is it a subtle appendicitis? How to make time your friend

How have you come to the hospital?

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

Acute appendicitis and signs

Acute appendicitis and Symptoms

Septic Arthritis

Septic Arthritis and Arthrocentesis

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