Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

Abstract

Unequivocal international guidelines regarding the diagnosis and management of patients with acute appendicitis are lacking. The aim of the consensus meeting 2015 of the EAES was to generate a European guideline based on best available evidence and expert opinions of a panel of EAES members. After a systematic review of the literature by an international group of surgical research fellows, an expert panel with extensive clinical experience in the management of appendicitis discussed statements and recommendations. Statements and recommendations with more than 70 % agreement by the experts were selected for a web survey and the consensus meeting of the EAES in Bucharest in June 2015. EAES members and attendees at the EAES meeting in Bucharest could vote on these statements and recommendations. In the case of more than 70 % agreement, the statement or recommendation was defined as supported by the scientific community. Results from both the web survey and the consensus meeting in Bucharest are presented as percentages. In total, 46 statements and recommendations were selected for the web survey and consensus meeting. More than 232 members and attendees voted on them. In 41 of 46 statements and recommendations, more than 70 % agreement was reached. All 46 statements and recommendations are presented in this paper. They comprise topics regarding the diagnostic work-up, treatment indications, procedural aspects and post-operative care. The consensus meeting produced 46 statements and recommendations on the diagnostic work-up and management of appendicitis. The majority of the EAES members supported these statements. These consensus proceedings provide additional guidance to surgeons and surgical residents providing care to patients with appendicitis. Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-016-5245-7) contains supplementary material, which is available to authorized users.

Meta-analysis of in-hospital delay before surgery as a risk factor for complications in patients with acute appendicitis

“…That meta‐analysis reported no significant difference in rates of complicated appendicitis when delay was less than 12 h or more than 12 h, or between less than 12 h and 12–24 h. The 2016 World Society of Emergency Surgery guideline concludes that an in‐hospital delay of up to 12–24 h is safe in uncomplicated appendicitis. The European Association for Endoscopic Surgery also published its guideline in 2016; this states that delaying an appendicectomy increases the risk of perforated appendicitis and therefore it is recommended that appendicectomy be performed as soon as possible.…”

Gastroenteritis Versus Appendicitis: A Case Study on Light of Clinical Assessment, Diagnostic CT Scan and Evidence Based Practice

“…Rarely, an appendiceal lumen filled with appendicoliths can mimic an opacified lumen on CT scans. Distal appendicitis can potentially be the cause of a false-negative interpretation (6,7,8,9). Back to our case which mentioned above.…”

Superioridad clínica de la apendicectomía laparoscópica sobre la técnica abierta: ¿adopción lenta de un nuevo estándar de tratamiento?

“…Las publicaciones más recientes refuerzan las conclusiones del estudio y sugieren la adopción de la apendicectomía laparoscópica como estándar de manejo [17][18][19][20] .…”