Practice Guideline

. 2021 May 11;16(1):23.

doi: 10.1186/s13017-021-00362-3.

WSES-AAST guidelines: management of inflammatory bowel disease in the emergency setting

Belinda De Simone¹, Justin Davies², Elie Chouillard³, Salomone Di Saverio⁴, Frank Hoentjen⁵, Antonio Tarasconi⁶, Massimo Sartelli⁷, Walter L Biffl⁸, Luca Ansaloni⁹, Federico Coccolini¹⁰, Massimo Chiarugi¹⁰, Nicola De'Angelis¹¹, Ernest E Moore¹², Yoram Kluger¹³, Fikri Abu-Zidan¹⁴, Boris Sakakushev¹⁵, Raul Coimbra¹⁶, Valerio Celentano¹⁷, Imtiaz Wani¹⁸, Tadeja Pintar¹⁹, Gabriele Sganga²⁰, Isidoro Di Carlo²¹, Dario Tartaglia²², Manos Pikoulis²³, Maurizio Cardi²⁴, Marc A De Moya²⁵, Ari Leppaniemi²⁶, Andrew Kirkpatrick²⁷, Vanni Agnoletti²⁸, Gilberto Poggioli²⁹, Paolo Carcoforo³⁰, Gian Luca Baiocchi³¹, Fausto Catena⁶

Affiliations

¹ Department of Metabolic, Digestive and Emergency Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy et Saint Germain en Laye, 10 rue du Champ Gaillard, 78303, Poissy, France. desimone.belinda@gmail.com.
² Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
³ Department of Metabolic, Digestive and Emergency Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy et Saint Germain en Laye, 10 rue du Champ Gaillard, 78303, Poissy, France.
⁴ Department of General Surgery, University of Insubria, University Hospital of Varese, ASST Sette Laghi, Regione Lombardia, Varese, Italy.
⁵ RIMLS - Radboud Institute for Molecular Life Sciences, Radboud University-Nijmegen Medical Center, Nijmegen, The Netherlands.
⁶ Department of Trauma and Emergency Surgery, Parma University Hospital, Parma, Italy.
⁷ Department of General Surgery, Macerata Hospital, Macerata, Italy.
⁸ Scripps Memorial Hospital La Jolla, San Diego, California, USA.
⁹ Department of Surgery, University Hospital of Pavia, Pavia, Italy.
¹⁰ Department of Emergency and Trauma Surgery, University Hospital of Pisa, Pisa, Italy.
¹¹ Minimally Invasive and Robotic Digestive Surgery Unit, Regional General Hospital F. Miulli, Acquaviva delle Fonti (Bari), Italy.
¹² Denver Health System - Denver Health Medical Center, Denver, USA.
¹³ Division of General Surgery, Rambam Health Care Campus, Haifa, Israel.
¹⁴ Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
¹⁵ First Clinic of General Surgery, University Hospital St George, Plovdiv, Bulgaria.
¹⁶ UCSD Health System - Hillcrest Campus Department of Surgery Chief Division of Trauma, Surgical Critical Care, Burns, and Acute Care Surgery, San Diego, CA, USA.
¹⁷ Department of Colorectal Surgery, Portsmouth Hospitals NHS Trust, Hampshire, UK.
¹⁸ Government Gousia Hospital-Srinagar, Directorate of Health Services-Kashmir, Srinagar, Kashmir, India.
¹⁹ Department of Abdominal Surgery, Umc Ljubljana, Ljubljana, Slovenia.
²⁰ Department of Emergency Surgery, "A. Gemelli Hospital", Catholic University of Rome, Rome, Italy.
²¹ Department of Surgical Sciences and Advanced Technologies, University of Catania, General Surgery, Cannizzaro Hospital, Catania, Italy.
²² Emergency Surgery Unit & Trauma Center, New Santa Chiara Hospital, University of Pisa, Pisa, Italy.
²³ 3rd Department of Surgery, Attikon General Hospital, National & Kapodistrian University of Athens (NKUA), Athens, Greece.
²⁴ Department of Oncological Surgery "P.Valdoni", Sapienza University, Rome, Italy.
²⁵ Trauma/Acute Care Surgery Department, Medical College of Wisconsin/Froedtert Trauma Center, Wauwatosa, Wisconsin, USA.
²⁶ Department of Abdominal Surgery, Abdominal Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
²⁷ General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery Foothills Medical Centre, Calgary, Alberta, Canada.
²⁸ ICU Department, Bufalini Hospital, Cesena, Italy.
²⁹ Department of Surgical Sciences, Policlinico Sant'Orsola Malpighi, Bologna, Italy.
³⁰ Department of Surgery, University Hospital of Ferrara, Ferrara, Italy.
³¹ Department of Surgery, University of Brescia, Brescia, Italy.

PMID: 33971899
PMCID: PMC8111988
DOI: 10.1186/s13017-021-00362-3

Practice Guideline

WSES-AAST guidelines: management of inflammatory bowel disease in the emergency setting

Belinda De Simone et al. World J Emerg Surg. 2021.

. 2021 May 11;16(1):23.

doi: 10.1186/s13017-021-00362-3.

Authors

Affiliations

¹ Department of Metabolic, Digestive and Emergency Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy et Saint Germain en Laye, 10 rue du Champ Gaillard, 78303, Poissy, France. desimone.belinda@gmail.com.
² Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
³ Department of Metabolic, Digestive and Emergency Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy et Saint Germain en Laye, 10 rue du Champ Gaillard, 78303, Poissy, France.
⁴ Department of General Surgery, University of Insubria, University Hospital of Varese, ASST Sette Laghi, Regione Lombardia, Varese, Italy.
⁵ RIMLS - Radboud Institute for Molecular Life Sciences, Radboud University-Nijmegen Medical Center, Nijmegen, The Netherlands.
⁶ Department of Trauma and Emergency Surgery, Parma University Hospital, Parma, Italy.
⁷ Department of General Surgery, Macerata Hospital, Macerata, Italy.
⁸ Scripps Memorial Hospital La Jolla, San Diego, California, USA.
⁹ Department of Surgery, University Hospital of Pavia, Pavia, Italy.
¹⁰ Department of Emergency and Trauma Surgery, University Hospital of Pisa, Pisa, Italy.
¹¹ Minimally Invasive and Robotic Digestive Surgery Unit, Regional General Hospital F. Miulli, Acquaviva delle Fonti (Bari), Italy.
¹² Denver Health System - Denver Health Medical Center, Denver, USA.
¹³ Division of General Surgery, Rambam Health Care Campus, Haifa, Israel.
¹⁴ Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
¹⁵ First Clinic of General Surgery, University Hospital St George, Plovdiv, Bulgaria.
¹⁶ UCSD Health System - Hillcrest Campus Department of Surgery Chief Division of Trauma, Surgical Critical Care, Burns, and Acute Care Surgery, San Diego, CA, USA.
¹⁷ Department of Colorectal Surgery, Portsmouth Hospitals NHS Trust, Hampshire, UK.
¹⁸ Government Gousia Hospital-Srinagar, Directorate of Health Services-Kashmir, Srinagar, Kashmir, India.
¹⁹ Department of Abdominal Surgery, Umc Ljubljana, Ljubljana, Slovenia.
²⁰ Department of Emergency Surgery, "A. Gemelli Hospital", Catholic University of Rome, Rome, Italy.
²¹ Department of Surgical Sciences and Advanced Technologies, University of Catania, General Surgery, Cannizzaro Hospital, Catania, Italy.
²² Emergency Surgery Unit & Trauma Center, New Santa Chiara Hospital, University of Pisa, Pisa, Italy.
²³ 3rd Department of Surgery, Attikon General Hospital, National & Kapodistrian University of Athens (NKUA), Athens, Greece.
²⁴ Department of Oncological Surgery "P.Valdoni", Sapienza University, Rome, Italy.
²⁵ Trauma/Acute Care Surgery Department, Medical College of Wisconsin/Froedtert Trauma Center, Wauwatosa, Wisconsin, USA.
²⁶ Department of Abdominal Surgery, Abdominal Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
²⁷ General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery Foothills Medical Centre, Calgary, Alberta, Canada.
²⁸ ICU Department, Bufalini Hospital, Cesena, Italy.
²⁹ Department of Surgical Sciences, Policlinico Sant'Orsola Malpighi, Bologna, Italy.
³⁰ Department of Surgery, University Hospital of Ferrara, Ferrara, Italy.
³¹ Department of Surgery, University of Brescia, Brescia, Italy.

PMID: 33971899
PMCID: PMC8111988
DOI: 10.1186/s13017-021-00362-3

Abstract

Background: Despite the current therapeutic options for the treatment of inflammatory bowel disease, surgery is still frequently required in the emergency setting, although the number of cases performed seems to have decreased in recent years. The World Society of Emergency Surgery decided to debate in a consensus conference of experts, the main pertinent issues around the management of inflammatory bowel disease in the emergent situation, with the need to provide focused guidelines for acute care and emergency surgeons.

Method: A group of experienced surgeons and gastroenterologists were nominated to develop the topics assigned and answer the questions addressed by the Steering Committee of the project. Each expert followed a precise analysis and grading of the studies selected for review. Statements and recommendations were discussed and voted at the Consensus Conference of the 6th World Society of Emergency Surgery held in Nijmegen (The Netherlands) in June 2019.

Conclusions: Complicated inflammatory bowel disease requires a multidisciplinary approach because of the complexity of this patient group and disease spectrum in the emergency setting, with the aim of obtaining safe surgery with good functional outcomes and a decreasing stoma rate where appropriate.

Keywords: Abscess; Crohn’s disease; Damage control surgery; Emergency surgery; Inflammatory bowel disease; Laparoscopy; Open abdomen; Percutaneous drainage; Perforation; Perianal sepsis; Peritonitis; SILS; Toxic megacolon; Ulcerative colitis.

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Conflict of interest statement

The authors declare that they have no competing interests.

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WSES-AAST guidelines: management of inflammatory bowel disease in the emergency setting

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WSES-AAST guidelines: management of inflammatory bowel disease in the emergency setting

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