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Review
. 2022 Jan 21;17(1):5.
doi: 10.1186/s13017-022-00408-0.

The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly

Paola Fugazzola  1 , Marco Ceresoli  2 , Federico Coccolini  3 , Francesco Gabrielli  2 , Alessandro Puzziello  4 , Fabio Monzani  5 , Bruno Amato  6 , Gabriele Sganga  7 , Massimo Sartelli  8 , Francesco Menichetti  9 , Gabriele Adolfo Puglisi  3 , Dario Tartaglia  3 , Paolo Carcoforo  10 , Nicola Avenia  11 , Yoram Kluger  12 , Ciro Paolillo  13 , Mauro Zago  14 , Ari Leppäniemi  15 , Matteo Tomasoni  16 , Lorenzo Cobianchi  16 , Francesca Dal Mas  17 , Mario Improta  18 , Ernest E Moore  19 , Andrew B Peitzman  20 , Michael Sugrue  21 , Vanni Agnoletti  22 , Gustavo P Fraga  23 , Dieter G Weber  24 , Dimitrios Damaskos  25 , Fikri M Abu-Zidan  26 , Imtiaz Wani  27 , Andrew W Kirkpatrick  28 , Manos Pikoulis  29 , Nikolaos Pararas  30 , Edward Tan  31 , Richard Ten Broek  31 , Ronald V Maier  32 , R Justin Davies  33 , Jeffry Kashuk  34 , Vishal G Shelat  35 , Alain Chicom Mefire  36 , Goran Augustin  37 , Stefano Magnone  38 , Elia Poiasina  38 , Belinda De Simone  39 , Massimo Chiarugi  3 , Walt Biffl  40 , Gian Luca Baiocchi  41 , Fausto Catena  42 , Luca Ansaloni  16
Affiliations
Review

The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly

Paola Fugazzola et al. World J Emerg Surg. .

Abstract

Acute left colonic diverticulitis (ALCD) in the elderly presents with unique epidemiological features when compared with younger patients. The clinical presentation is more nuanced in the elderly population, having higher in-hospital and postoperative mortality. Furthermore, geriatric comorbidities are a risk factor for complicated diverticulitis. Finally, elderly patients have a lower risk of recurrent episodes and, in case of recurrence, a lower probability of requiring urgent surgery than younger patients. The aim of the present work is to study age-related factors that may support a unique approach to the diagnosis and treatment of this problem in the elderly when compared with the WSES guidelines for the management of acute left-sided colonic diverticulitis. During the 1° Pisa Workshop of Acute Care & Trauma Surgery held in Pisa (Italy) in September 2019, with the collaboration of the World Society of Emergency Surgery (WSES), the Italian Society of Geriatric Surgery (SICG), the Italian Hospital Surgeons Association (ACOI), the Italian Emergency Surgery and Trauma Association (SICUT), the Academy of Emergency Medicine and Care (AcEMC) and the Italian Society of Surgical Pathophysiology (SIFIPAC), three panel members presented a number of statements developed for each of the four themes regarding the diagnosis and management of ALCD in older patients, formulated according to the GRADE approach, at a Consensus Conference where a panel of experts participated. The statements were subsequently debated, revised, and finally approved by the Consensus Conference attendees. The current paper is a summary report of the definitive guidelines statements on each of the following topics: diagnosis, management, surgical technique and antibiotic therapy.

Keywords: Acute diverticulitis; 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
WSES left colonic diverticulitis classification [17]
Fig. 2
Fig. 2
Voting results
Fig. 3
Fig. 3
Management algorithm for patients older than 65 years with suspected AD
See this image and copyright information in PMC

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