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Review
. 2020 Mar 10;15(1):19.
doi: 10.1186/s13017-020-00298-0.

The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)

Paola Fugazzola  1 , Marco Ceresoli  2 , Vanni Agnoletti  3 , Ferdinando Agresta  4 , Bruno Amato  5 , Paolo Carcoforo  6 , Fausto Catena  7 , Osvaldo Chiara  8 , Massimo Chiarugi  9 , Lorenzo Cobianchi  10 , Federico Coccolini  9 , Alessandro De Troia  6 , Salomone Di Saverio  11 , Andrea Fabbri  12 , Carlo Feo  6 , Francesco Gabrielli  2 , Angela Gurrado  13 , Angelo Guttadauro  2 , Leonardo Leone  14 , Daniele Marrelli  15 , Luca Petruzzelli  16 , Nazario Portolani  17 , Francesco Paolo Prete  18 , Alessandro Puzziello  19 , Massimo Sartelli  20 , Giorgio Soliani  6 , Mario Testini  18 , Salvatore Tolone  21 , Matteo Tomasoni  22 , Gregorio Tugnoli  23 , Pierluigi Viale  24 , Monica Zese  6 , Offir Ben Ishay  25 , Yoram Kluger  25 , Andrew Kirkpatrick  26 , Luca Ansaloni  22
Affiliations
Review

The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)

Paola Fugazzola et al. World J Emerg Surg. .

Abstract

The epidemiology and the outcomes of acute appendicitis in elderly patients are very different from the younger population. Elderly patients with acute appendicitis showed higher mortality, higher perforation rate, lower diagnostic accuracy, longer delay from symptoms onset and admission, higher postoperative complication rate and higher risk of colonic and appendiceal cancer. The aim of the present work was to investigate age-related factors that could influence a different approach, compared to the 2016 WSES Jerusalem guidelines on general population, in terms of diagnosis and management of elderly patient with acute appendicitis. During the XXIX National Congress of the Italian Society of Surgical Pathophysiology (SIFIPAC) held in Cesena (Italy) in May 2019, in collaboration with the Italian Society of Geriatric Surgery (SICG), the World Society of Emergency Surgery (WSES) and the Italian Society of Emergency Medicine (SIMEU), a panel of experts participated to a Consensus Conference where eight panelists presented a number of statements, which were developed for each of the four topics about diagnosis and management of acute appendicitis in elderly patients, formulated according to the GRADE system. The statements were then voted, eventually modified and finally approved by the participants to the Consensus Conference. The current paper is reporting the definitive guidelines statements on each of the following topics: diagnosis, non-operative management, operative management and antibiotic therapy.

Keywords: Appendectomy; Appendicitis; Elderly; Surgery in elderly.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Voting results
Fig. 2
Fig. 2
Management algorithm for patients older than 65 years old with suspected AA
See this image and copyright information in PMC

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