Salomone Di Saverio, Maggiore Hospital
Arianna Birindelli, University of Bologna
Micheal D. Kelly, Canberra Hospital
Fausto Catena, Maggiore Hospital of Parma
Dieter G. Weber, Royal Perth Hospital, The University of Western Australia
Massimo Sartelli, Macerata Hospital
Michael Sugrue, Letterkenny Hospital
Mark De Moya, Massachusetts General Hospital
Carlos Augusto Gomes, Universidade General de Juiz de Fora
Aneel Bhangu, University Hospitals Birmingham
Ferdinando Agresta, Civil Hospital - ULSS19
Ernest E. Moore, Denver Health Medical Center
Kjetil Soreide, Stavanger University Hospital
Ewen Griffiths, University Hospitals Birmingham
Steve De Castro, OLVG
Jeffry Kashuk, University of Jerusalem
Yoram Kluger, Rambam Health Care Campus
Ari Leppaniemi, University of Helsinki
Luca Ansaloni, Papa Giovanni XXIII Hospital
Manne Andersson, Linkoping University
Federico Coccolini, Papa Giovanni XXIII Hospital
Raul Coimbra, UCSD Health System
Kurinchi S. Gurusamy, University College London
Fabio Cesare Campanile, San Giovanni Decollato Andosilla Hospital
Walter Biffl, University of Hawaii
Osvaldo Chiara, Niguarda Hospital
Fred Moore, University of Florida
Andrew B. Peitzman, University of Pittsburgh
Gustavo P. Fraga, Faculdade de Ciências Médicas
David Costa
Ronald V. Maier, University of Washington
Sandro Rizoli, St. Michael Hospital
Zsolt J. Balogh, John Hunter Hospital, University of Newcastle
Cino Bendinelli, John Hunter Hospital, University of Newcastle
Roberto Cirocchi, University of Perugia
Valeria Tonini, University of Bologna
Alice Piccinini, Maggiore Hospital
Gregorio Tugnoli, Maggiore Hospital
Elio Jovine, Maggiore Hospital
Roberto Persiani, Catholic University, A. Gemelli University Hospital
Antonio Biondi, University of Catania
Thomas Scalea, R. Adams Cowley Trauma Center
Philip Stahel, Denver Health Medical Center
Rao Ivatury, Virginia Commonwealth University
George Velmahos, Harvard Medical School, Massachusetts General Hospital
Roland Andersson, Linkoping University

Document Type


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Journal/Book/Conference Title

World Journal of Emergency Surgery





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June 2017


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.


© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, 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 ( applies to the data made available in this article, unless otherwise stated.

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