Epidemiology, pathophysiology, diagnosis and management of acute appendicitis

Patients with acute abdominal pain with suspicion of appendicitis are common. The etiology and pathophysiology of acute appendicitis is not well understood, and the management of patients with suspicion of appendicitis is controversial.

The main goals of this long term project are to elucidate the natural history and to investigate the pathophysiology of acute appendicitis, to improve the clinical diagnosis and to define the role of diagnostic imaging techniques and laparoscopy in the structured management of patients with suspicion of appendicitis.

Within this project we use epidemiologic techniques to analyse different aspects about appendicitis, like mortality, long term associations of appendicitis and appendectomy with other intestinal inflammatory conditions like inflammatory bowel disease and diverticulitis and to analyse the effects of the implementation of the laparoscopic technique in the management of appendicitis.

We also analyse the impact of environmental factors during infancy, mainly breastfeeding and exposure to tobacco, on the risk of having acute appendicitis later in life.

We use immunologic techniques to study the systemic and local inflammatory response in appendicitis to elucidate the pathogenesis of appendicitis and to find useful diagnostic markers of especially advanced appendicitis.

In prospective clinical multicenter studies we search means to improve the clinical diagnosis of appendicitis and to define the role of diagnostic imaging in the structured management of patients with suspicion of appendicitis.

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Salomone Di Saverio, Mauro Podda, Belinda De Simone, Marco Ceresoli, Goran Augustin, Alice Gori, Marja Boermeester, Massimo Sartelli, Federico Coccolini, Antonio Tarasconi, Nicola de Angelis, Dieter G. Weber, Matti Tolonen, Arianna Birindelli, Walter Biffl, Ernest E. Moore, Michael Kelly, Kjetil Soreide, Jeffry Kashuk, Richard Ten Broek, Carlos Augusto Gomes, Michael Sugrue, Richard Justin Davies, Dimitrios Damaskos, Ari Leppaniemi, Andrew Kirkpatrick, Andrew B. Peitzman, Gustavo P. Fraga, Ronald V. Maier, Raul Coimbra, Massimo Chiarugi, Gabriele Sganga, Adolfo Pisanu, Gian Luigi de Angelis, Edward Tan, Harry Van Goor, Francesco Pata, Isidoro Di Carlo, Osvaldo Chiara, Andrey Litvin, Fabio C. Campanile, Boris Sakakushev, Gia Tomadze, Zaza Demetrashvili, Rifat Latifi, Fakri Abu-Zidan, Oreste Romeo, Helmut Segovia-Lohse, Gianluca Baiocchi, David Costa, Sandro Rizoli, Zsolt J. Balogh, Cino Bendinelli, Thomas Scalea, Rao Ivatury, George Velmahos, Roland Andersson, Yoram Kluger, Luca Ansaloni, Fausto Catena (2020) Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines World Journal of Emergency Surgery , Vol. 15 Continue to DOI