why this blog?

Likelihood Ratio (LR) in Emergency Medicine


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

Clinical Scenario

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 gallblader.  

Take antiacid said my doctor and don’t smoke – he says – I’m worried, Is it an ulcer? I wish to consult a gastroenterologist.


It’s well known that dyspepsia is one of the most frequent symptoms in ED. 
Differential diagnosis between organic and functional dyspepsia based on symptoms and clinical examination assessed either by a gastroenterologist or others has a little weight.   
And so?

Shall we prescribe an endoscopy?

Ciro Paolillo



  1. Thank you for sharing valuable information. Nice post. I enjoyed reading this post. The whole blog is very nice found some good stuff and good information here Thanks..Also visit my page Life Science jobs .

  2. http://www.emergency-medicine1.tk/

  3. Excellent information on your blog, thank you for taking the time to share with us.Very informative and well written post! Quite interesting and nice topic chosen for the post Nice Post keep it up.Excellent post.
    bruce a. kehr m.d.