409
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

      research-article
      1 , , 2 , 3 , 4 , 5 , 6 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 7 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 43 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 51 , 63 , 64 , 65 , 66 , 27 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 27 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 6 , 90 , 91 , 92 , 93 , 39 , 94 , 95 , 96 , 97 , 98 , 99 , 93 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 75 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 58 , 115 , 116 , 117 , 118 , 119 , 112 , 120 , 7 , 121 , 122 , 1 , 123 , 14 , 124 , 125 , 126 , 127 , 128 , 124 , 129 , 130 , 131 , 132 , 60 , 109 , 8
      World Journal of Emergency Surgery : WJES
      BioMed Central
      Acute appendicitis, Diagnosis, Management, Surgery, Antibiotics

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments.

          Methods

          This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016–September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study.

          Results

          A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%.

          Conclusions

          The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.

          Related collections

          Most cited references52

          • Record: found
          • Abstract: found
          • Article: not found

          The epidemiology of appendicitis and appendectomy in the United States.

          To describe the epidemiology of appendicitis and appendectomy in the United States, the authors analyzed National Hospital Discharge Survey data for the years 1979-1984. Approximately 250,000 cases of appendicitis occurred annually in the United States during this period, accounting for an estimated 1 million hospital days per year. The highest incidence of primary positive appendectomy (appendicitis) was found in persons aged 10-19 years (23.3 per 10,000 population per year); males had higher rates of appendicitis than females for all age groups (overall rate ratio, 1.4:1). Racial, geographic, and seasonal differences were also noted. Appendicitis rates were 1.5 times higher for whites than for nonwhites, highest (15.4 per 10,000 population per year) in the west north central region, and 11.3% higher in the summer than in the winter months. The highest rate of incidental appendectomy was found in women aged 35-44 years (43.8 per 10,000 population per year), 12.1 times higher than the rate for men of the same age. Between 1970 and 1984, the incidence of appendicitis decreased by 14.6%; reasons for this decline are unknown. A life table model suggests that the lifetime risk of appendicitis is 8.6% for males and 6.7% for females; the lifetime risk of appendectomy is 12.0% for males and 23.1% for females. Overall, an estimated 36 incidental procedures are performed to prevent one case of appendicitis; for the elderly, the preventive value of an incidental procedure is considerably lower.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            A practical score for the early diagnosis of acute appendicitis.

            We conducted a retrospective study of 305 patients hospitalized with abdominal pain suggestive of acute appendicitis. Signs, symptoms, and laboratory findings were analyzed for specificity, sensitivity, predictive value, and joint probability. The total joint probability, the sum of a true-positive and a true-negative result, was chosen as a diagnostic weight indicative of the accuracy of the test. Eight predictive factors were found to be useful in making the diagnosis of acute appendicitis. Their importance, according to their diagnostic weight, was determined as follows: localized tenderness in the right lower quadrant, leukocytosis, migration of pain, shift to the left, temperature elevation, nausea-vomiting, anorexia-acetone, and direct rebound pain. Based on this weight, we devised a practical diagnostic score that may help in interpreting the confusing picture of acute appendicitis.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

              Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.
                Bookmark

                Author and article information

                Contributors
                massimosartelli@gmail.com
                gianluca.baiocchi@unibs.it
                salo75@inwind.it
                frr.fra@gmail.com
                labricciosafrancesco@gmail.com
                aiace63@gmail.com
                Federico.coccolini@gmail.com
                dvijayan@nhs.net
                ashrafabbaas@hotmail.com
                hariscine@yahoo.it
                owoade14@gmail.com
                mrahmed1010@yahoo.com
                laliakhmeteli@gmail.com
                akkapulu@gmail.com
                sakkucuk@mku.edu.tr
                fatihaltintoprak@yahoo.com
                julia.andreiev@gmail.com
                danyfantakis@med.uoc.gr
                doktor_boiko@abv.bg
                rbalam@hadassah.org.il
                dbalalis@gmail.com
                oubaraket@gmail.com
                giovanni.bellanova@asl.ta.it
                beltran_01@yahoo.com
                rbmelo@med.up.pt
                re.bini@libero.it
                kwstisbool@yahoo.com
                danielebrunelli2009@libero.it
                ARCastillo@mednet.ucla.edu
                marco.catani@uniroma1.it
                asricj@yahoo.com
                alainchichom@yahoo.com
                gianfranco.cocorullo@unipa.it
                rcoimbra@ucsd.edu
                elifmangancolak@hotmail.com
                sisse.costa@gmail.com
                koraydas@yahoo.com
                sam.delibey@gmail.com
                zdemetr@yahoo.com
                idicarlo@unict.it
                nadja86lv@gmail.com
                dtzalabany@hotmail.com
                mariofaro31@hotmail.com
                margarida.s.f@gmail.com
                fragagp2008@gmail.com
                gachabayovmahir@gmail.com
                wghnnam@gmail.com
                teresagm87@gmail.com
                georgiokas@yahoo.com
                caxiaogomes@gmail.com
                ewen.griffiths@uhb.nhs.uk
                draliguner@yahoo.com
                sandiv99@yahoo.co.uk
                andreas.hecker@chiru.med.uni-giessen.de
                elciohirano@ig.com.br
                hodasm98@gmail.com
                matohuto@yahoo.com
                orestisioannidis@gmail.com
                kararda@yahoo.com
                ivakhovsurg@yandex.ru
                sumitajain@gmail.com
                mantas910317@gmail.com
                alekara@sbb.rs
                saila.kauhanen@utu.fi
                robinkaushik@yahoo.com
                alfiejose@gmail.com
                jkenig@cm-uj.krakow.pl
                docvladimir@yandex.ru
                desmond.khor@usc.edu
                dekim@dhs.lacounty.gov
                erythrokim@paik.ac.kr
                Victorywkong@yahoo.com
                kwstaslasith@yahoo.gr
                pedroleao@ecsaude.uminho.pt
                miguel.leon.arellano@gmail.com
                aalitvin@gmail.com
                BOLLOON@HOTMAIL.COM
                dretomassetti@gmail.com
                e.lostoridis@gmail.com
                infonew@wses.org.uk
                majorpiotr@gmail.com
                Anamajsecb@gmail.com
                dmanatak@yahoo.gr
                drmarinis@gmail.com
                aleix.martinez.perez@gmail.com
                drsanjay.marwah@gmail.com
                michaelm500@yahoo.com
                mesina.cristian@doctor.com
                michal.pedziwiatr@uj.edu.pl
                nickos.michalopoulos@gmail.com
                misiakos@med.uoa.gr
                dr.aliyasen@yahoo.com
                rmoldovanu@gmail.com
                giulia.montori@gmail.com
                dr.raghuveermn@gmail.com
                negoiionut@gmail.com
                inikolopoulos@gmail.com
                novelligiuseppe@yahoo.it
                dr.viktors.novikovs@gmail.com
                tunde_olaoye_dr@yahoo.com
                akomari@just.edu.jo
                ordonezcarlosa@gmail.com
                mouaqit3001@gmail.com
                drzeynepozkan@yahoo.com
                akpal.jnmc@yahoo.com
                palinigm@yahoo.it
                partecke@uni-greifswald.de
                francesco.pata@gmail.com
                info@wses.org.uk
                gersonapj@gmail.com
                tadeja.pintar@kclj.si
                magdalenapisarska@interia.pl
                plonecef@gmail.com
                marketing@wses.org.uk
                cghert@yahoo.co.in
                drrpadmakumar@gmail.com
                regimbeau.jean-marc@chu-amiens.fr
                reitzmm@gmail.com
                jobzon@hotmail.com
                stensaars@gmail.com
                bsakakushev@gmail.com
                babismed@gmail.com
                ivakhov@rambler.ru
                vgshelat@rediffmail.com
                matej.skrovina@nnj.agel.cz
                surgeon.smirnov@yahoo.com
                charisspyropoulos@gmail.com
                marcin.strzalka@uj.edu.pl
                peep.talving@perh.ee
                novo02@uol.com.br
                george.theobald@nhs.net
                giatomadze@gmail.com
                myftartorba@yahoo.com
                trana.cristian@gmail.com
                Jan.Ulrych@vfn.cz
                drmyuzunoglu@gmail.com
                vasilescu.alin@gmail.com
                chsvn@unife.it
                auvenara@yahoo.fr
                vereczkei.andras@pte.hu
                nereovet@gmail.com
                nutu.vlad@gmail.com
                maciej.waledziak@gmail.com
                utku.yilmaz@kocaeli.edu.tr
                traumayuan@gmail.com
                yunfengcuidoctor@aliyun.com
                justas.zilinskas@gmail.com
                Grelpois.Gerard@chu-amiens.fr
                fausto.catena@gmail.com
                Journal
                World J Emerg Surg
                World J Emerg Surg
                World Journal of Emergency Surgery : WJES
                BioMed Central (London )
                1749-7922
                16 April 2018
                16 April 2018
                2018
                : 13
                : 19
                Affiliations
                [1 ]Department of Surgery, Macerata Hospital, Macerata, Italy
                [2 ]ISNI 0000000417571846, GRID grid.7637.5, Department of Clinical and Experimental Sciences, , University of Brescia, ; Brescia, Italy
                [3 ]ISNI 0000 0004 1759 7093, GRID grid.416290.8, Emergency Surgery, , Maggiore Hospital, ; Bologna, Italy
                [4 ]GRID grid.414126.4, General Surgery and Polytrauma, , San Carlo Borromeo Hospital, ; Milan, Italy
                [5 ]Department of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health, UNIVPM, Ancona, Italy
                [6 ]ISNI 0000 0004 1758 8744, GRID grid.414682.d, Department of Surgery, , Bufalini Hospital, ; Cesena, Italy
                [7 ]ISNI 0000 0004 0376 6589, GRID grid.412563.7, General Surgery, , University Hospitals Birmingham NHS Foundation Trust, ; Birmingham, UK
                [8 ]GRID grid.469958.f, Emergency Surgery, , Mansoura University Hospital, ; Mansoura, Egypt
                [9 ]GRID grid.411482.a, Emergency Surgery Unit, , Maggiore University Hospital, ; Parma, Italy
                [10 ]Surgery, Kwara State General Hospital, Ilorin, Kwara Nigeria
                [11 ]ISNI 0000 0004 4688 7583, GRID grid.413221.7, Surgery, , Ahmadu Bello University Teaching Hospital Zaria, ; Zaria, Nigeria
                [12 ]Surgery, First University Clinic, Tbilisi, Georgia
                [13 ]ISNI 0000 0001 1457 1144, GRID grid.411548.d, General Surgery, , Baskent Universitesi Adana Eğitim ve Uygulama Hastanesi, ; Adana, Turkey
                [14 ]ISNI 0000 0001 0680 7823, GRID grid.14352.31, General Surgery, , Training and Research Hospital of Mustafa Kemal University, ; Hatay, Turkey
                [15 ]ISNI 0000 0001 0682 3030, GRID grid.49746.38, General Surgery, , Sakarya University School of Medicine, ; Sakarya, Turkey
                [16 ]Primary Care, Primary Health Care Centre of Kissamos, Chania, Greece
                [17 ]ISNI 0000 0001 0726 0380, GRID grid.35371.33, Department of General Surgery, , Medical University of Plovdiv, UMHAT Eurohospital, ; Plovdiv, Bulgaria
                [18 ]ISNI 0000 0001 2221 2926, GRID grid.17788.31, General Surgery, , Hadassah Medical Center, ; Jerusalem, Israel
                [19 ]Surgical Department, Agios Savvas Anticaner Hospital, Athens, Greece
                [20 ]General Surgery, Hospital Habib Bouguefa de Bizerte, Bizerte, Tunisia
                [21 ]General Surgery, S.S. Annunziata Hospital, Taranto, Italy
                [22 ]Surgery, Hospital San Juan de Dios de La Serena, La Serena, Chile
                [23 ]ISNI 0000 0000 9375 4688, GRID grid.414556.7, General Surgery, , Centro Hospitalar São João, ; Porto, Portugal
                [24 ]ISNI 0000 0004 1760 7116, GRID grid.415044.0, General and Emergency Surgery, , San Giovanni Bosco Hospital, ; Turin, Italy
                [25 ]Surgical Department, General Hospital of Larissa, Larissa, Greece
                [26 ]Chirurgia, Città di Castello Hospital, Città di Castello, Italy
                [27 ]ISNI 0000 0001 0157 6501, GRID grid.239844.0, Department of Surgery, , Harbor-UCLA Medical Center, ; Torrance, USA
                [28 ]GRID grid.7841.a, DEA, La Sapienza Università di Roma, Policlinico Umberto I, ; Rome, Italy
                [29 ]General Surgery, Kuala Krai Hospital, Kuala Krai, Kelantan Malaysia
                [30 ]Surgery and Obstetrics/Gynaecology, Regional Hospital, Limbe, Cameroon
                [31 ]ISNI 0000 0004 1756 3088, GRID grid.412510.3, Emergency Surgery, , Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, ; Palermo, Italy
                [32 ]ISNI 0000 0001 2107 4242, GRID grid.266100.3, Trauma/Acute Care Surgery, , University of California San Diego, ; San Diego, USA
                [33 ]General Surgery, Samsun Training and Research Hospital, Samsun, Turkey
                [34 ]ISNI 0000 0000 8902 4519, GRID grid.418336.b, Surgery, , CHVNG/E, EPE, ; Vila Nova de Gaia, Portugal
                [35 ]ISNI 0000 0004 0642 7670, GRID grid.413791.9, General Surgery, , Numune Training and Research Hospital, ; Adana, Turkey
                [36 ]ISNI 0000 0001 0682 9061, GRID grid.412410.2, Colorectal Surgery, Clinic for Surgery, , University Clinical Center Tuzla, ; Tuzla, Bosnia and Herzegovina
                [37 ]Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia
                [38 ]ISNI 0000 0004 0637 437X, GRID grid.413542.5, Surgery, , Hamad General Hospital, ; Doha, Qatar
                [39 ]ISNI 0000 0004 0375 2558, GRID grid.488518.8, General and Emergency Surgery, , Riga East University Hospital “Gailezers”, ; Riga, Latvia
                [40 ]General Surgery, Bahrain Defence Force Hospital, Manama, Bahrain
                [41 ]ISNI 0000 0004 0643 8839, GRID grid.412368.a, Department of General Surgery, Trauma and Emergency Surgery Division, , ABC Medical School, ; Santo Andreì, SP Brazil
                [42 ]ISNI 0000 0000 8563 4416, GRID grid.414708.e, General Surgery, , Hospital Garcia de Orta, ; Lisbon, Portugal
                [43 ]ISNI 0000 0001 0723 2494, GRID grid.411087.b, Division of Trauma Surgery, Hospital de Clinicas, , University of Campinas (Unicamp), ; Campinas, Brazil
                [44 ]Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia
                [45 ]ISNI 0000000103426662, GRID grid.10251.37, General Surgery Department, Mansoura Faculty of Medicine, , Mansoura University, ; Mansoura, Egypt
                [46 ]ISNI 0000 0000 9854 2756, GRID grid.411106.3, Cirugía General y del Aparato Digestivo, , Hospital Universitario Miguel Servet, ; Zaragoza, Spain
                [47 ]ISNI 0000 0001 2155 0800, GRID grid.5216.0, Second Department of Surgery, , Aretaieion University Hospital, National and Kapodistrian University of Athens, ; Athens, Greece
                [48 ]Surgery, Therezinha de Jesus University Hospital, Juiz de Fora, Brazil
                [49 ]ISNI 0000 0004 0376 6589, GRID grid.412563.7, Upper GI/General Surgery, , University Hospitals Birmingham NHS Foundation Trust, ; Birmingham, UK
                [50 ]ISNI 0000 0001 2186 0630, GRID grid.31564.35, Department of General Surgery, , Karadeniz Technical University, Farabi Hospital, ; Trabzon, Turkey
                [51 ]ISNI 0000 0004 1767 2831, GRID grid.413220.6, Surgery, , Government Medical College and Hospital, ; Chandigarh, India
                [52 ]ISNI 0000 0000 8584 9230, GRID grid.411067.5, Department of General and Thoracic Surgery, , University Hospital, ; Giessen, Germany
                [53 ]Chirurgie, Chud-Borgou/Alibori, Parakou, Benin
                [54 ]Surgical Department, Landesklinikum Hainburg, Hainburg An Der Donau, Austria
                [55 ]ISNI 0000000109457005, GRID grid.4793.9, 4th Surgical Department, , Aristotle University of Thessaloniki, ; Thessaloniki, Greece
                [56 ]GRID grid.414012.2, General Hospital “George Papanikoalou”, ; Thessaloniki, Greece
                [57 ]ISNI 0000 0001 1498 7262, GRID grid.412176.7, General Surgery, , Erzincan University Mengucek Gazi Training and Research Hospital, ; Erzincan, Turkey
                [58 ]General Surgery, City Hospital #1, Moscow, Russia
                [59 ]ISNI 0000 0004 1767 3615, GRID grid.416077.3, Surgery, , S M S Medical college, ; Jaipur, India
                [60 ]ISNI 0000 0004 0575 8750, GRID grid.48349.32, Department of Surgery, , Hospital of Lithuanian University of Health Sciences Kaunas Clinics, ; Kaunas, Lithuania
                [61 ]ISNI 0000 0001 2166 9385, GRID grid.7149.b, Clinic for Emergency Surgery, , Faculty of Medicine University of Belgrade, ; Belgrade, Serbia
                [62 ]ISNI 0000 0004 0628 215X, GRID grid.410552.7, Division of Digestive Surgery and Urology, , Turku University Hospital, ; Turku, Finland
                [63 ]ISNI 0000 0004 1802 2603, GRID grid.464600.0, General Surgery, , Jubilee Mission Medical College & Research Institute, ; Thrissur, India
                [64 ]ISNI 0000 0001 2162 9631, GRID grid.5522.0, 3rd Department of General Surgery, , Jagiellonian University Medical College, ; Krakow, Poland
                [65 ]Emergency surgery, City Hospital, Mozyr, Belarus
                [66 ]ISNI 0000 0001 0084 1895, GRID grid.411409.9, Acute Care Surgery, , LAC+USC Medical Center, ; California, USA
                [67 ]ISNI 0000 0004 0371 8173, GRID grid.411633.2, Department of Surgery, , Inje University Ilsan Paik Hospital, ; Goyang, Republic of Korea
                [68 ]ISNI 0000 0004 0576 7753, GRID grid.414386.c, Department of Surgery, , Edendale Hospital, ; Pietermaritzburg, South Africa
                [69 ]General Surgery, Scarborough, York Teaching Hospital, Scarborough, UK
                [70 ]General Surgery, Colorectal Unit, Hospital de Braga, Braga, Portugal
                [71 ]GRID grid.419651.e, General and Digestive Surgery, , Hospital Fundación Jimenez Diaz, ; Madrid, Spain
                [72 ]Surgical Disciplines, Regional Clinical Hospital, Kaliningrad, Russia
                [73 ]GRID grid.416009.a, Faculty of Medicine, Department of Surgery, , Siriraj Hospital, Mahidol University, ; Bangkok, Thailand
                [74 ]Department of Gastrointestinal Surgery, Insular University Hospital of Gran Canaria, Las Palmas, Spain
                [75 ]1st Department of Surgery, Kavala General Hospital, Kavala, Greece
                [76 ]ISNI 0000 0001 2162 9631, GRID grid.5522.0, 2nd Department of Surgery, , Jagiellonian University Medical College, ; Krakow, Poland
                [77 ]ISNI 0000 0004 0397 9648, GRID grid.412688.1, Clinic of surgery, Department of Gastrointestinal Surgery, , University Hospital Centre Zagreb, ; Zagreb, Croatia
                [78 ]GRID grid.414012.2, Surgical Department, , Konstantopouleio General Hospital, ; Athens, Greece
                [79 ]GRID grid.417374.2, First Department of Surgery, , Tzaneio, ; Piraeus, Greece
                [80 ]ISNI 0000 0004 1770 9825, GRID grid.411289.7, Department of General and Digestive Surgery, , Hospital Universitario Doctor Peset, ; Valencia, Spain
                [81 ]ISNI 0000 0004 1771 1642, GRID grid.412572.7, Department of General Surgery, , Post-Graduate Institute of Medical Sciences, ; Rohtak, India
                [82 ]ISNI 0000 0001 2322 4996, GRID grid.12916.3d, Department of Surgery, Radiology, Anaesthetics and Intensive Care, , University of the West Indies, ; Kingston, Jamaica
                [83 ]ISNI 0000 0004 0500 5353, GRID grid.412963.b, University Hospital of the West Indies, ; Kingston, Jamaica
                [84 ]Department of Surgery Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania
                [85 ]ISNI 0000 0001 1216 0093, GRID grid.412700.0, Department of General Surgery and Emergency Medicine, , University Hospital, ; Kraków, Poland
                [86 ]ISNI 0000 0004 0576 4544, GRID grid.411222.6, 3rd Department of Surgery, , Ahepa University Hospital, ; Thessaloniki, Greece
                [87 ]ISNI 0000 0001 2155 0800, GRID grid.5216.0, 3rd Department of Surgery, , Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, ; Athens, Greece
                [88 ]General Surgery, Khartoum Teaching Hospital, Khartoum, Sudan
                [89 ]Department of Visceral, Digestive and Oncologic Surgery, Clinique Sainte Marie, Cambrai, France
                [90 ]General Surgery, K R Hospital, Mysore, India
                [91 ]General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
                [92 ]GRID grid.429537.e, General Surgery, , Lewisham and Greenwich NHS Trust, ; London, UK
                [93 ]GRID grid.414614.2, General, Emergency Surgery, , Infermi Hospital, ; Rimini, Italy
                [94 ]ISNI 0000 0000 8878 5287, GRID grid.412975.c, Surgery, , University of Ilorin Teaching Hospital, ; Ilorin, Nigeria
                [95 ]ISNI 0000 0004 0411 3985, GRID grid.460946.9, General Surgery, , King Abdullah University Hospital, ; Irbid, Jordan
                [96 ]GRID grid.477264.4, Division of Trauma and Acute Care Surgery, Department of Surgery, , Fundación Valle del Lili and Universidad del Valle, ; Cali, Colombia
                [97 ]Surgery Departement, Medical School of Fezm, Sidi Mohamed Benabdellah University, Fez, Morocco
                [98 ]General Surgery, Elazig Training and Research Hospital, Elazig, Turkey
                [99 ]ISNI 0000 0004 0645 6578, GRID grid.411275.4, General Surgery, , King George’s Medical University, ; Lucknow, India
                [100 ]Surgery, University Hospital, Greifswald, Germany
                [101 ]Department of General Surgery, Sant’Antonio Abate Hospital, Gallarate, Italy
                [102 ]ISNI 0000 0001 1216 0093, GRID grid.412700.0, Department of Emergency Surgery and Trauma Centre, , University Hospital, ; Kraków, Poland
                [103 ]GRID grid.460710.4, Surgery and Anatomy, , Clinics Hospital, ; Ribeirão Preto, Brazil
                [104 ]ISNI 0000 0004 0571 7705, GRID grid.29524.38, Abdominal surgery, , UMC Ljubljana, ; Ljubljana, Slovenia
                [105 ]ISNI 0000 0001 1216 0093, GRID grid.412700.0, Department of Endoscopic, Metabolic and Soft Tissue Tumors Surgery, , The University Hospital in Krakow, ; Kraków, Poland
                [106 ]ISNI 0000 0001 0432 668X, GRID grid.459608.6, General Surgery, , Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, ; Guadalajara, Mexico
                [107 ]ISNI 0000 0004 0503 0903, GRID grid.411681.b, Surgery, , Bharati Vidyapeeth Deemed University Medical College & Hospital, ; Sangli, Maharashtra India
                [108 ]Laparoscopic and Metabolic Surgery, KIMS Hospital, Cochin, India
                [109 ]ISNI 0000 0004 0593 702X, GRID grid.134996.0, Digestive Surgery, , CHU Amiens-Picardie, ; Amiens, France
                [110 ]General Surgery, Hospital Municipal Dr. Jose de Carvalho Florence, Sao Jose Dos Campos, Brazil
                [111 ]General Surgery, Hospital General Regional # 1 I.M.S.S, Cuernavaca, Mexico
                [112 ]Acute Care Surgery, North Estonia Medical Center, Tallinn, Estonia
                [113 ]General Surgery, University Hospital St George, Plovdiv, Bulgaria
                [114 ]ISNI 0000 0004 0399 9948, GRID grid.416281.8, General Surgery, , Russells Hall Hospital, ; Birmingham, UK
                [115 ]GRID grid.240988.f, General Surgery, , Tan Tock Seng Hospital, ; Singapore, Singapore
                [116 ]Surgery, Hospital & Oncological Centre Novy Jicin, Novy Jicin, Czech Republic
                [117 ]General Surgery, Clinical Hospital at Chelyabinsk Station OJSC “Russian Railways”, Chelyabinsk, Russian Federation
                [118 ]GRID grid.452503.5, 3rd Department of Surgery, , IASO General Hospital, ; Athens, Greece
                [119 ]ISNI 0000 0001 2162 9631, GRID grid.5522.0, General Surgery and Polytrauma, , University Hospital, Medical College, Jagiellonian University, ; Kraków, Poland
                [120 ]Cirurgia do Trauma, Hospital Escola Padre Albino, Catanduva, Brazil
                [121 ]ISNI 0000 0004 0428 8304, GRID grid.412274.6, Surgery Department #2, , Tbilisi State Medical University, ; Tbilisi, Georgia
                [122 ]General Surgery, Trauma University Hospital, Tirana, Albania
                [123 ]ISNI 0000 0000 9100 9940, GRID grid.411798.2, 1st Department of Surgery—Department of Abdominal Thoracic Surgery and Traumatology, , General University Hospital, ; Prague, Czech Republic
                [124 ]First Surgical Clinic, St. Spiridon University Hospital, Iasi, Romania
                [125 ]Emergency Surgery, S. Anna Teaching Hospital, Ferrara, Italy
                [126 ]ISNI 0000 0004 0472 0283, GRID grid.411147.6, Digestive and Endocrinal Surgery, , University Hospital, ; Angers, France
                [127 ]ISNI 0000 0001 0663 9479, GRID grid.9679.1, Department of Surgery, , Medical School University of Pécs, ; Pécs, Hungary
                [128 ]Surgery, ASTS Spedali Civili Brescia, Montichiari, Italy
                [129 ]ISNI 0000 0004 0620 0839, GRID grid.415641.3, Department of General, Oncological, Metabolic and Thoracic Surgery, , Military Institute of Medicine in Warsaw, ; Warsaw, Poland
                [130 ]ISNI 0000 0001 0691 9040, GRID grid.411105.0, Department of General Surgery, , Kocaeli University, ; Kocaeli, Turkey
                [131 ]Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
                [132 ]GRID grid.417036.7, Department of Surgery, , Tianjin Nankai Hospital, ; Tianjin, China
                Article
                179
                10.1186/s13017-018-0179-0
                5902943
                29686725
                5f49aa82-8806-473d-b36c-dc385df0d8e7
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 December 2017
                : 4 April 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Surgery
                acute appendicitis,diagnosis,management,surgery,antibiotics
                Surgery
                acute appendicitis, diagnosis, management, surgery, antibiotics

                Comments

                Comment on this article