WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis
Иерусалимские рекомендации WSES по диагностике и лечению острого аппендицита
2016-07-18
SCID: 54.1/f3nmpqpn
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acute appendicitisappendectomy timingclinical scoring systemsdiagnostic imagingnon-operative treatment
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Abstract (AI)
Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.
Key Findings
1
It evaluates the diagnostic efficiency of clinical scoring systems for estimating appendicitis probability and guiding subsequent management.
2
Management recommendations cover non-operative treatment for uncomplicated appendicitis, appendectomy timing, surgical treatment, and intra-operative severity scoring.
3
The guidelines also address non-surgical treatment of appendiceal abscess or phlegmon and the use of pre-operative and post-operative antibiotics.
4
The guidelines examine the roles of ultrasonography, computed tomography, and magnetic resonance imaging in acute appendicitis diagnosis.
5
The paper establishes comprehensive, consensus-based guidelines for diagnosing and managing acute appendicitis, addressing eight major clinical questions.
Research Object
acute appendicitis
Research Subject
diagnosis and treatment, including diagnostic assessment, imaging, operative and non-operative management, timing of appendectomy, grading, and antibiotic use
Publication Details
Publication Date
2016-07-18
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