Clinical Scenario A 67 y/o woman arrives in the ED at 5pm because of diffused abdominal pain since 2 hours. She has nausea and she refers costipation from the day…
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Clinical Scenario 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…
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Clinical scenario 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…
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Clinical Scenario 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.…
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Clinical scenario 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 rule out an acute appendicitis, but it could be useful  to identifypatients that may have complicated appendicitis. In previous post we have pointed out the poor utility of signs and symptoms alone to screen patients with or withoutan acute appendicitis.…
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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…
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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…
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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,…
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A 84 y/o woman comes accompained by relatives for abdominal pain. She is oriented and cooperative, she suffers pain (NRS 10/10). Abdomen is treatable, but very painful in the lower…
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  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…
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