- Title
- Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines
- Creator
- Di Saverio, Salomone; Podda, Mauro; de' Angelis, Nicola; Weber, Dieter G.; Tolonen, Matti; Birindelli, Arianna; Biffl, Walter; Moore, Ernest E.; Kelly, Michael; Soreide, Kjetil; Kashuk, Jeffry; Ten Broek, Richard; De Simone, Belinda; Gomes, Carlos Augusto; Sugrue, M; Davies, RJ; Damaskos, D; Leppaniemi, A; Kirkpatrick, A; Peitzman, AB; Fraga, GP; Maier, RV; Coimbra, R; Ceresoli, Marco; Chiarugi, M; Sganga, G; Pisanu, A; de' Angelis, GL; Tan, E; Van Goor, H; Pata, F; Di Carlo, I; Chiara, O; Litvin, A; Augustin, Goran; Campanile, FC; Sakakushev, B; Tomadze, G; Demetrashvili, Z; Latifi, R; Abu-Zidan, F; Romeo, O; Segovia-Lohse, H; Baiocchi, G; Costa, D; Gori, Alice; Rizoli, S; Balogh, Zsolt J.; Bendinelli, Cino; Scalea, T; Ivatury, R; Velmahos, G; Andersson, R; Kluger, Y; Ansaloni, L; Catena, F; Boermeester, Marja; Sartelli, Massimo; Coccolini, Federico; Tarasconi, Antonio
- Relation
- World Journal of Emergency Surgery Vol. 15, Issue 1, no. 27
- Publisher Link
- http://dx.doi.org/10.1186/s13017-020-00306-3
- Publisher
- BioMed Central (BMC)
- Resource Type
- journal article
- Date
- 2020
- Description
- Background and aims: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Methods: This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. Conclusions: The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hospital delay, (4) surgical treatment, (5) intra-operative grading of AA, (6) ,management of perforated AA with phlegmon or abscess, and (7) peri-operative antibiotic therapy.
- Subject
- acute appendicits; appendicitis guidelines; antibiotics; complicated appendicitis; appendectomy; laparoscopic appendectomy; diagnostic laparoscopy; phlegmon; appendiceal abscess; Jerusalem guidelines; consensus conference; Alvarado score; appendicitis diagnosis score; adult appendicitis score; imaging; CT scan appendicitis; non-operative management
- Identifier
- http://hdl.handle.net/1959.13/1433156
- Identifier
- uon:39172
- Identifier
- ISSN:1749-7922
- Rights
- © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
- Language
- eng
- Full Text
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