Metrics details. 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.
Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July , 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.
Acute appendicitis AA is a common cause of acute abdominal pain, which can progress to perforation and peritonitis, associated with morbidity and mortality. The lifetime risk of appendicitis is 8. Despite numerous studies on AA, many unresolved issues remain, including aetiology and treatment. The diagnosis of AA is a constellation of history, physical examination coupled with laboratory investigations, supplemented by selective focused imaging. These can be used in combination in scoring systems.
Various clinical scoring systems have been proposed in order to predict AA with certainty, but none has been widely accepted.
