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Tarasconi A, Perrone G, Davies J, et al. Anorectal emergencies: WSES-AAST guidelines. World J Emerg Surg. 2021;16(1):48doi: 10.1186/s13017-021-00384-x.
Tarasconi, A., Perrone, G., Davies, J., Coimbra, R., Moore, E., Azzaroli, F., Abongwa, H., De Simone, B., Gallo, G., Rossi, G., Abu-Zidan, F., Agnoletti, V., de'Angelis, G., de'Angelis, N., Ansaloni, L., Baiocchi, G. L., Carcoforo, P., Ceresoli, M., Chichom-Mefire, A., Di Saverio, S., Gaiani, F., Giuffrida, M., Hecker, A., Inaba, K., Kelly, M., Kirkpatrick, A., Kluger, Y., Leppäniemi, A., Litvin, A., Ordoñez, C., Pattonieri, V., Peitzman, A., Pikoulis, M., Sakakushev, B., Sartelli, M., Shelat, V., Tan, E., Testini, M., Velmahos, G., Wani, I., Weber, D., Biffl, W., Coccolini, F., & Catena, F. (2021). Anorectal emergencies: WSES-AAST guidelines. World journal of emergency surgery : WJES, 16(1), 48. https://doi.org/10.1186/s13017-021-00384-x
Tarasconi, Antonio, et al. "Anorectal emergencies: WSES-AAST guidelines." World journal of emergency surgery : WJES vol. 16,1 (2021): 48. doi: https://doi.org/10.1186/s13017-021-00384-x
Tarasconi A, Perrone G, Davies J, Coimbra R, Moore E, Azzaroli F, Abongwa H, De Simone B, Gallo G, Rossi G, Abu-Zidan F, Agnoletti V, de'Angelis G, de'Angelis N, Ansaloni L, Baiocchi GL, Carcoforo P, Ceresoli M, Chichom-Mefire A, Di Saverio S, Gaiani F, Giuffrida M, Hecker A, Inaba K, Kelly M, Kirkpatrick A, Kluger Y, Leppäniemi A, Litvin A, Ordoñez C, Pattonieri V, Peitzman A, Pikoulis M, Sakakushev B, Sartelli M, Shelat V, Tan E, Testini M, Velmahos G, Wani I, Weber D, Biffl W, Coccolini F, Catena F. Anorectal emergencies: WSES-AAST guidelines. World J Emerg Surg. 2021 Sep 16;16(1):48. doi: 10.1186/s13017-021-00384-x. PMID: 34530908; PMCID: PMC8447593.
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World J Emerg Surg. 2021 Sep 16;16(1):48. doi: 10.1186/s13017-021-00384-x.

Anorectal emergencies: WSES-AAST guidelines.

World journal of emergency surgery : WJES

Antonio Tarasconi, Gennaro Perrone, Justin Davies, Raul Coimbra, Ernest Moore, Francesco Azzaroli, Hariscine Abongwa, Belinda De Simone, Gaetano Gallo, Giorgio Rossi, Fikri Abu-Zidan, Vanni Agnoletti, Gianluigi de'Angelis, Nicola de'Angelis, Luca Ansaloni, Gian Luca Baiocchi, Paolo Carcoforo, Marco Ceresoli, Alain Chichom-Mefire, Salomone Di Saverio, Federica Gaiani, Mario Giuffrida, Andreas Hecker, Kenji Inaba, Michael Kelly, Andrew Kirkpatrick, Yoram Kluger, Ari Leppäniemi, Andrey Litvin, Carlos Ordoñez, Vittoria Pattonieri, Andrew Peitzman, Manos Pikoulis, Boris Sakakushev, Massimo Sartelli, Vishal Shelat, Edward Tan, Mario Testini, George Velmahos, Imtiaz Wani, Dieter Weber, Walter Biffl, Federico Coccolini, Fausto Catena

Affiliations

  1. Emergency Surgery Department, Parma University Hospital, Parma, Italy. [email protected].
  2. Emergency Surgery Department, Parma University Hospital, Parma, Italy.
  3. Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  4. Riverside University Health System Medical Center, Loma Linda University School of Medicine, Riverside, CA, USA.
  5. Ernest E. Moore Shock Trauma Center at Denver Health, Denver, CO, USA.
  6. Gastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
  7. Department of Metabolic, Digestive and Emergency Surgery, Centre Hospitalier Intercommunal de Poissy et Saint Germain en Laye, Poissy, France.
  8. Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy.
  9. Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
  10. Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Cesena, Italy.
  11. Department of Medicine and Surgery, University of Parma, Parma, Italy.
  12. Gastroenterology and Endoscopy Unit, Hospital of Parma, Parma, Italy.
  13. Minimally Invasive and Robotic Digestive Surgery Unit, Regional General Hospital F. Miulli, Bari, Ital - Université Paris Est, UPEC, Creteil, France.
  14. Department of Emergency and general Surgery, Pavia University Hospital, Pavia, Italy.
  15. Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
  16. Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.
  17. General Surgery, Monza University Hospital, Monza, Italy.
  18. Faculty of Health Sciences, Department of Surgery, University of Buea, Buea, Cameroon.
  19. General surgery 1st unit, Department of General Surgery, University of Insubria, Varese, Italy.
  20. Department of Medicine and Surgery, General Surgery Unit, University Hospital of Parma, Parma, Italy.
  21. Department of General & Thoracic Surgery, University Hospital of Giessen, Giessen, Germany.
  22. Division of Acute Care Surgery, University of Southern California, Los Angeles, CA, USA.
  23. Department of General Surgery, Albury Hospital, Albury, Australia.
  24. General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, Alberta, Canada.
  25. Division of General Surgery, Rambam Health Care Campus, Haifa, Israel.
  26. Helsinki University Hospital, Helsinki, Finland.
  27. Department of Surgical Disciplines, Regional Clinical Hospital, Immanuel Kant Baltic Federal University, Kaliningrad, Russia.
  28. Department of Surgery, Fundacion Valle del Lili - Universidad del Valle, Cali, Colombia.
  29. University of Pittsburgh School of Medicine, UPMC-Presbyterian, Pittsburgh, PA, USA.
  30. 3rd Department of Surgery, National & Kapodistrian University of Athens, Athens, Greece.
  31. General Surgery Department, University Hospital St George, Plovdiv, Bulgaria.
  32. Department of Surgery, Macerata Hospital, Macerata, Italy.
  33. Department of Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
  34. Department of Surgery, Department of Emergency Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
  35. Academic Unit of General Surgery "V. Bonomo" Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy.
  36. Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, MA, USA.
  37. Government Gousia Hospital, Srinagar, Kashmir, India.
  38. Department of General Surgery, Royal Perth Hospital, University of Western Australia, Perth, Australia.
  39. Department of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, San Diego, CA, USA.
  40. General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy.
  41. General, Emergency and Trauma Surgery Dept., Bufalini Hospital, Cesena, Italy.

PMID: 34530908 PMCID: PMC8447593 DOI: 10.1186/s13017-021-00384-x

Abstract

Anorectal emergencies comprise a wide variety of diseases that share common symptoms, i.e., anorectal pain or bleeding and might require immediate management. While most of the underlying conditions do not need inpatient management, some of them could be life-threatening and need prompt recognition and treatment. It is well known that an incorrect diagnosis is frequent for anorectal diseases and that a delayed diagnosis is related to an impaired outcome. This paper aims to improve the knowledge and the awareness on this specific topic and to provide a useful tool for every physician dealing with anorectal emergencies.The present guidelines have been developed according to the GRADE methodology. To create these guidelines, a panel of experts was designed and charged by the boards of the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) to perform a systematic review of the available literature and to provide evidence-based statements with immediate practical application. All the statements were presented and discussed during the WSES-AAST-WJES Consensus Conference on Anorectal Emergencies, and for each statement, a consensus among the WSES-AAST panel of experts was reached. We structured our work into seven main topics to cover the entire management of patients with anorectal emergencies and to provide an up-to-date, easy-to-use tool that can help physicians and surgeons during the decision-making process.

© 2021. The Author(s).

Keywords: Angiography; Anorectal Varices; Anorectal bleeding; Anorectal foreign bodies ; Anorectal sepsis; Antibiotics; Diagnosis; Embolization; Fournier’s gangrene; Guidelines; Hemorrhoids; Non-operative management; Surgery; Technique; Timing

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