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Clinical diagnosis of gastric ulcer. Does your gastroenerologist perform better?

A 35 yo smokerman presents at morning to the ED. He refers epigastric pain since seven days. The pain worses after eating, he refers nausea without vomit and he denies melena and weight loss. Palpation causes pain in epigastric region, there’s not fever, nor tachicardia, hemoglobin is 13 g/dL. Bedside US evidences a normal…

ByCiro Paolillo11 January 20140Comments

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

Pleuritic pain and radio-occult lesion

A 33 y/o woman, comes to the ED because of a sudden emithorax pain localized on the left in basal region. The pain is described as stabbing, well localised, it worsen with inspirium …a pleuritic pain, no cough, no fever, not hemoptysis. She smokes, she does not take any medication. Chest x ray is normal.…

ByIlenia Spallino11 October 20120Comments

Abdomen

Rectal Examination and Appendicitis

A 25 y/o man comes to the ED because of abdominal pain started 2 hours before, fever and vomit. He has not history of disease, no history of surgery, no history of other ED admission for abdominal pain. Clinical examination shows rigidity and diffused painfull abdomen. You perform digital rectal examination were you evidence no…

ByIlenia Spallino18 March 20120Comments

The Emergency Physician

Clinical diagnosis of gastric ulcer. Does your gastroenerologist perform better?

Atypical or typical, is this the question?

Pleuritic pain and radio-occult lesion

Rectal Examination and Appendicitis

Septic Arthritis

Septic Arthritis and Arthrocentesis

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