Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
World Journal of Emergency Surgery
Published in: World Journal of Emergency Surgery 1/2015

Open Access 01-12-2015 | Review

A proposal for a CT driven classification of left colon acute diverticulitis

Authors: Massimo Sartelli, Frederick A Moore, Luca Ansaloni, Salomone Di Saverio, Federico Coccolini, Ewen A Griffiths, Raul Coimbra, Ferdinando Agresta, Boris Sakakushev, Carlos A Ordoñez, Fikri M Abu-Zidan, Aleksandar Karamarkovic, Goran Augustin, David Costa Navarro, Jan Ulrych, Zaza Demetrashvili, Renato B Melo, Sanjay Marwah, Sanoop K Zachariah, Imtiaz Wani, Vishal G Shelat, Jae Il Kim, Michael McFarlane, Tadaja Pintar, Miran Rems, Miklosh Bala, Offir Ben-Ishay, Carlos Augusto Gomes, Mario Paulo Faro, Gerson Alves Pereira Jr, Marco Catani, Gianluca Baiocchi, Roberto Bini, Gabriele Anania, Ionut Negoi, Zurabs Kecbaja, Abdelkarim H Omari, Yunfeng Cui, Jakub Kenig, Norio Sato, Andras Vereczkei, Matej Skrovina, Koray Das, Giovanni Bellanova, Isidoro Di Carlo, Helmut A Segovia Lohse, Victor Kong, Kenneth Y Kok, Damien Massalou, Dmitry Smirnov, Mahir Gachabayov, Georgios Gkiokas, Athanasios Marinis, Charalampos Spyropoulos, Ioannis Nikolopoulos, Konstantinos Bouliaris, Jaan Tepp, Varut Lohsiriwat, Elif Çolak, Arda Isik, Daniel Rios-Cruz, Rodolfo Soto, Ashraf Abbas, Cristian Tranà, Emanuele Caproli, Darija Soldatenkova, Francesco Corcione, Diego Piazza, Fausto Catena

Published in: World Journal of Emergency Surgery | Issue 1/2015

Login to get access

Abstract

Computed tomography (CT) imaging is the most appropriate diagnostic tool to confirm suspected left colonic diverticulitis. However, the utility of CT imaging goes beyond accurate diagnosis of diverticulitis; the grade of severity on CT imaging may drive treatment planning of patients presenting with acute diverticulitis.
The appropriate management of left colon acute diverticulitis remains still debated because of the vast spectrum of clinical presentations and different approaches to treatment proposed. The authors present a new simple classification system based on both CT scan results driving decisions making management of acute diverticulitis that may be universally accepted for day to day practice.
Literature
1.
2.
Laméris W, Van Randen A, Van Gulik TM, Bush OR, Winkelhagen J, Bossuyt PM, et al.: A clinical decision rule to establish the diagnosis of acute diverticulitis at the emergency department. Dis Colon Rectum. 2010, 53:896–904. 10.1007/DCR.0b013e3181d98d86CrossRefPubMed
3.
Ricciardi R, Baxter NN, Read TE, Marcello PW, Hall J, Roberts PL: Is the decline in the surgical treatment for diverticulitis associated with an increase in complicated diverticulitis? Dis Colon rectum. 2009, 52:1558–63. 10.1007/DCR.0b013e3181a90a5bCrossRefPubMed
4.
Alonso S, Pera M, Parès D, Pascual M, Gil MJ, Courtier R, et al.: Outpatient treatment of patients with uncomplicated acute diverticulitis. Colorectal Dis. 2010, 12:278–82. 10.1111/j.1463-1318.2009.02122.xCrossRef
5.
McDermott F, Collins D, Heeney A, Winter D: Minimally invasive and surgical management strategies tailored to the severity of acute diverticulitis. Br J Surg. 2014, 101:90–9. 10.1002/bjs.9359CrossRef
6.
Morris AM, Regenbogen SE, Hardiman KM, Hendren S: Sigmoid diverticulitis: a systematic review. JAMA. 2014, 311:287–97. 10.1001/jama.2013.282025CrossRefPubMed
7.
Andeweg CS, Mulder IM, Felt-Bersma RJ, Verbon A, van der Wilt GJ, van Goor H, et al.: Guidelines of diagnostics and treatment of acute left-sided colonic diverticulitis. Dig Surg. 2013, 30:278–92. 10.1159/000354035CrossRefPubMed
8.
Hinchey EJ, Schaal PH, Richards MB: Treatment of perforated diverticular disease of the colon. Adv Surg. 1978, 12:85–109.PubMed
9.
Laméris W, Van Randen A, Bossuyt PMM, Bipat S, Bossuyt PM, Boermeester MA, et al.: Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol. 2008, 18:2498–511. 10.1007/s00330-008-1018-6CrossRefPubMed
10.
Ambrosetti P, Jenny A, Becker C, Terrier TF, Morel P: Acute left colonic diverticulitis–compared performance of computed tomography and water-soluble contrast enema: prospective evaluation of 420 patients. Dis Colon Rectum. 2000, 43:1363–7. 10.1007/BF02236631CrossRefPubMed
11.
Ambrosetti P: Acute diverticulitis of the left colon: value of the initial CT and timing of elective colectomy. J Gastrointest Surg. 2008, 12:1318–20. 10.1007/s11605-008-0489-8CrossRefPubMed
12.
Ambrosetti P, Becker C, Terrier F: Colonic diverticulitis: impact of imaging on surgical management: a prospective study of 542 patients. Eur Radiol. 2002, 12:1145–9. 10.1007/s00330-001-1143-yCrossRefPubMed
13.
Kaiser AM, Jiang JK, Lake JP: The management of complicated diverticulitis and the role of computed tomography. Am J Gastroent. 2005, 100:910–7. 10.1111/j.1572-0241.2005.41154.xCrossRefPubMed
14.
Kohler L, Sauerland S, Neugebauer E: Diagnosis and treatment of diverticular disease: results of a consensus development conference. The scientific committee of the European association for endoscopic surgery. Surg Endosc 1999, 13:430–6. 10.1007/s004649901007CrossRefPubMed
15.
Sher ME, Agachan F, Bortul M: Laparoscopic surgery for diverticulitis. Surg Endosc. 1997, 11:264–7. 10.1007/s004649900340CrossRefPubMed
16.
Wasvary H, Turfah F, Kadro O: Same hospitalization resection for acute diverticulitis. Am Surg. 1999, 65:632–5.PubMed
17.
Moore FA, Catena F, Moore EE, Leppaniemi A, Peitzmann AB: Position paper: management of perforated sigmoid diverticulitis. World J Emerg Surg 2013, 8:55. 10.1186/1749-7922-8-55CrossRefPubMedCentralPubMed
18.
Klarenbeek BR, De Korte N, van der Peet DL, Cuesta MA: Review of current classifications for diverticular disease and a translation into clinical practice. Int J Colorectal Dis. 2012, 27:207–14. 10.1007/s00384-011-1314-5CrossRefPubMedCentralPubMed
19.
20.
Andeweg CS, Wegdam JA, Groenewoud J, van der Wilt GJ, van Goor H, Bleichrodt RP: Toward an evidence-based step-up approach in diagnosing diverticulitis. Scand J Gastroenterol. 2014, 49:775–84. 10.3109/00365521.2014.908475CrossRefPubMed
21.
Mazzei MA, Cioffi Squitieri N, Guerrini S, Stabile Ianora AA, Cagini L, Macarini L, et al.: Sigmoid diverticulitis: US findings. Crit Ultrasound J. 2013, 5:5. 10.1186/2036-7902-5-5CrossRef
22.
Swank HA, Vermeulen J, Lange JF, Mulder IM, van der Hoeven JA, Stassen LP, et al.: The ladies trial: laparoscopic peritoneal lavage or resection for purulent peritonitis and Hartmann's procedure or resection with primary anastomosis for purulent or faecal peritonitis in perforated diverticulitis (NTR2037). BMC Surg. 2010, 10:29. 10.1186/1471-2482-10-29CrossRefPubMedCentralPubMed
23.
Hansen O, Graupe F, Stock W: Prognostic factors in perforating diverticulitis of the large intestine. Chirurg. 1998, 69:443–9. 10.1007/s001040050436CrossRefPubMed
24.
Köhler L, Sauerland S, Neugebauer E: Diagnosis and treatment of diverticular disease: results of a consensus development conference. The Scientific Committee of the European Association for Endoscopic Surgery. Surg Endosc. 1999, 13:430–6. 10.1007/s004649901007CrossRefPubMed
25.
Regenbogen SE, Hardiman KM, Hendren S, Morris AM: Surgery for Diverticulitis in the 21st Century: a systematic review. JAMA Surg. 2014, 149:292–303. 10.1001/jamasurg.2013.5477CrossRefPubMed
26.
de Korte N, Kuyvenhoven JP, van der Peet DL, Felt-Bersma RJ, Cuesta MA, Stockmann HB: Mild colonic diverticulitis can be treated without antibiotics. A case–control study. Colorectal Dis 2012, 14:325–30. 10.1111/j.1463-1318.2011.02609.xCrossRefPubMed
27.
Chabok A, Påhlman L, Hjern F, Haapaniemi S, Smedh K, AVOD Study Group: Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg. 2012, 99:532–9. 10.1002/bjs.8688CrossRefPubMed
28.
Shabanzadeh DM, Wille-Jørgensen P: Antibiotics for uncomplicated diverticulitis. Cochrane Database Syst Rev. 2012., 11: CD009092
29.
Etzioni DA, Chiu VY, Cannom RR, Burchette RJ, Haigh PI, Abbas MA: Outpatient treatment of acute diverticulitis: rates and predictors of failure. Dis Colon Rectum. 2010, 53:861–5. 10.1007/DCR.0b013e3181cdb243CrossRefPubMed
30.
Jackson JD, Hammond T: Systematic review: outpatient management of acute uncomplicated diverticulitis. Int J Colorectal Dis. 2014, 29:775–81. 10.1007/s00384-014-1900-4CrossRefPubMed
31.
Rodrìguez-Cerrillo M, Poza-Montoro A, Fernandez-Diaz E, Matesanz-David M, Inurrieta RA: Treatment of elderly patients with uncomplicated diverticulitis, even with comorbidity, at home. Eur J Intern Med. 2013, 24:430–2. 10.1016/j.ejim.2013.03.016CrossRefPubMed
32.
Biondo S, Golda T, Kreisler E, Espin E, Vallribera F, Oteiza F, et al.: Outpatient versus hospitalization management for uncomplicated diverticulitis: a prospective, multicenter randomized clinical trial (DIVER Trial). Ann Surg. 2014, 259:38–44. 10.1097/SLA.0b013e3182965a11CrossRefPubMed
33.
Sartelli M, Viale P, Catena F, Ansaloni L, Moore E, Malangoni M, et al.: 2013 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg. 2013, 8:3. 10.1186/1749-7922-8-3CrossRefPubMedCentralPubMed
34.
Kumar RR, Kim JT, Haukoos JS, Macias LH, Dixon MR, Stamos MJ, et al.: Factors affecting the successful management of intra-abdominal abscesses with antibiotics and the need for percutaneous drainage. Dis Colon Rectum. 2006, 49:183–9. 10.1007/s10350-005-0274-7CrossRefPubMed
35.
Brandt D, Gervaz P, Durmishi Y, Platon A, Morel P, Poletti PA: Percutaneous CT scan-guided drainage versus antibiotherapy alone for Hinchey II diverticulitis: a case–control study. Dis Colon Rectum. 2006, 49:1533–8. 10.1007/s10350-006-0613-3CrossRefPubMed
36.
Andersen JC, Bundgaard L, Elbrønd H, Laurberg S, Walker LR, Støvring J, et al.: Danish national guidelines for treatment of diverticular disease. Dan Med J. 2012, 59:C4453.PubMed
37.
Feingold D, Steele SR, Lee S, Kaiser A, Boushey R, Buie WD, et al.: Practice parameters for the treatment of sigmoid diverticulitis. Dis Colon Rectum. 2014, 57:284–94. 10.1097/DCR.0000000000000075CrossRefPubMed
38.
Yeo ES, Ng KH, Eu KW: Perforated colorectal cancer: an important differential diagnosis in all presumed diverticular abscesses. Ann Acad Med Singapore 2011,40(8):375–8.PubMed
39.
Sallinen V, Mentula P, Leppäniemi A: Risk of colon cancer after computed tomography-diagnosed acute diverticulitis: is routine colonoscopy necessary? Surg Endosc 2014,28(3):961–6. 10.1007/s00464-013-3257-0CrossRefPubMed
40.
Durmishi Y, Gervaz P, Brandt D, Bucher P, Platon A, Morel P, et al.: Results from percutaneous drainage of Hinchey stage II diverticulitis guided by computed tomography scan. Surg Endosc. 2006, 20:1129–33. 10.1007/s00464-005-0574-yCrossRefPubMed
41.
Siewert B, Tye G, Kruskal J, Sosna J, Opelka F: Impact of CT-guided drainage in the treatment of diverticular abscess: size matters. AJR Am J Roentgenol. 2006, 186:680–6. 10.2214/AJR.04.1708CrossRefPubMed
42.
Ambrosetti P, Chautems R, Soravia C, Peiris-Waser N, Terrier F: Long-term outcome of mesocolic and pelvic diverticular abscesses of the left colon: a prospective study of 73 cases. Dis Colon Rectum. 2005, 48:787–91. 10.1007/s10350-004-0853-zCrossRefPubMed
43.
Dharmarajan S, Hunt SR, Birnbaum EH, Fleshman JW, Mutch MG: The efficacy of nonoperative management of acute complicated diverticulitis. Dis Colon Rectum. 2011, 54:663–71. 10.1007/DCR.0b013e31820ef759CrossRefPubMed
44.
Sallinen VJ, Mentula PJ, Leppäniemi AK: Nonoperative management of perforated diverticulitis with extraluminal air is safe and effective in selected patients. Dis Colon Rectum. 2014, 57:875–81. 10.1097/DCR.0000000000000083CrossRefPubMed
45.
Abbas S: Resection and primary anastomosis in acute complicated diverticulitis, a systematic review of the literature. Int J Colorectal Dis. 2007, 22:351–7. 10.1007/s00384-005-0059-4CrossRefPubMed
46.
Fleming FJ, Gillen P: Reversal of Hartmann's procedure following acute diverticulitis: is timing everything? Int J Colorectal Dis. 2009, 24:1219–25. 10.1007/s00384-009-0747-6CrossRefPubMed
47.
Herzog T, Janot M, Belyaev O, Sülberg D, Chromik AM, Bergmann U, et al.: Complicated sigmoid diverticulitis–Hartmann's procedure or primary anastomosis? Acta Chir Belg. 2011, 111:378–83.PubMed
48.
Myers E, Winter DC: Adieu to Henri Hartmann? Colorectal Dis. 2010, 12:849–50. 10.1111/j.1463-1318.2009.01909.xCrossRefPubMed
49.
Trenti L, Biondo S, Golda T, Monica M, Kreisler E, Fraccalvieri D, et al.: Generalized peritonitis due to perforated diverticulitis: Hartmann's procedure or primary anastomosis? Int J Colorectal Dis. 2011, 26:377–84. 10.1007/s00384-010-1071-xCrossRefPubMed
50.
Biondo S, Jaurrieta E, Martí Ragué J, Ramos E, Deiros M, Moreno P, et al.: Role of resection and primary anastomosis of the left colon in the presence of peritonitis. Br J Surg. 2000, 87:1580–4. 10.1046/j.1365-2168.2000.01556.xCrossRefPubMed
51.
Salem L, Flum DR: Primary anastomosis or Hartmann’s procedure for patients with diverticular peritonitis? A systematic review. Dis Colon Rectum. 2004, 47:1953–64. 10.1007/s10350-004-0701-1CrossRefPubMed
52.
Toro A, Mannino M, Reale G, Cappello G, Di Carlo I: Primary anastomosis vs Hartmann procedure in acute complicated diverticulitis. Evolution over the last twenty years. Chirurgia. 2012, 107:598–604.PubMed
53.
Kreis ME, Mueller MH, Thasler WH: Hartmann's Procedure or primary anastomosis? Dig Dis. 2012, 30:83–5. 10.1159/000335726CrossRefPubMed
54.
Masoomi H, Stamos MJ, Carmichael JC, Nguyen B, Buchberg B, Mills S: Does primary anastomosis with diversion have Any advantages over Hartmann's procedure in acute diverticulitis? Dig Surg. 2012, 29:315–20. 10.1159/000342549CrossRefPubMed
55.
Tadlock M, Karamanos E, Skiada D, Inaba K, Talving P, Senagore A, et al.: Emergency surgery for acute diverticulitis: which operation? A National Surgical Quality Improvement Program study. J Trauma Acute Care Surg. 2013, 74:1385–91. 10.1097/TA.0b013e3182924a82CrossRefPubMed
56.
Oberkofler CE, Rickenbacher A, Raptis DA, Lehmann K, Villiger P, Buchli C, et al.: A multicenter randomized clinical trial of primary anastomosis or Hartmann’s procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg. 2012, 256:819–26. 10.1097/SLA.0b013e31827324baCrossRefPubMed
57.
Myers E, Hurley M, O’Sullivan GC, Kavanagh D, Wilson I, Winter DC: Laparoscopic peritoneal lavage for generalized peritonitis due to perforated diverticulitis. Br J Surg. 2008, 95:97–101.CrossRefPubMed
58.
Afshar S, Kurer MA: Laparoscopic peritoneal lavage for perforated sigmoid diverticulitis. Colorectal Dis. 2012, 14:135–42. 10.1111/j.1463-1318.2011.02606.xCrossRefPubMed
59.
Agresta F, Ansaloni L, Baiocchi GL, Bergamini C, Campanile FC, Carlucci M, et al.: Laparoscopic approach to acute abdomen from the ConsensusDevelopment Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d'Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell'Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES). Surg Endosc. 2012, 26:2134–64. 10.1007/s00464-012-2331-3CrossRefPubMed
60.
Karoui M, Champault A, Pautrat K, Valleur P, Cherqui D, Champault G: Laparoscopic peritoneal lavage or primary anastomosis with defunctioning stoma for Hinchey 3 complicated diverticulitis: results of a comparative study. Dis Colon Rectum. 2009, 52:609–15. 10.1007/DCR.0b013e3181a0a674CrossRefPubMed
61.
Rossi GL, Mentz R, Bertone S, Ojea Quintana G, Bilbao S, Im VM, et al.: Laparoscopic Peritoneal Lavage for Hinchey III Diverticulitis: is it as effective as it is applicable? Dis Colon Rectum. 2014, 57:1384–90. 10.1097/DCR.0000000000000252CrossRefPubMed
62.
Swank HA, Mulder IM, Hoofwijk AG, Nienhuijs SW, Lange JF, Bemelman WA, et al.: Early experience with laparoscopic lavage for perforated diverticulitis. Br J Surg. 2013, 8:704–10.CrossRef
63.
Angenete E, Thornell A, Burcharth J, Pommergaard HC, Skullman S, Bisgaard T, et al.: Laparoscopic Lavage Is Feasible and Safe for the Treatment of Perforated Diverticulitis With Purulent Peritonitis: The First Results From the Randomized Controlled Trial DILALA. Ann Surg 2014. [Epub ahead of print]
64.
Zingg U, Pasternak I, Dietrich M, Seifert B, Oertli D, Metzger U: Primary anastomosis vs Hartmann's procedure in patients undergoing emergency left colectomy for perforated diverticulitis. Colorectal Dis. 2010, 12:54–60.CrossRefPubMed
65.
Jiménez M, Costa D: Resection and primary anastomosis without diverting Ileostomy for left colon emergencies: is it a safe procedure? World J Surg. 2012, 36:1148–53. 10.1007/s00268-012-1513-4CrossRef
66.
Rotondo MF, Mc Gonigol MD, Schwab CW, Kauder DR, Hanson CW: Damage control: an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma. 1993, 35:375–83. 10.1097/00005373-199309000-00008CrossRefPubMed
67.
Weber DG, Bendinelli C, Balogh ZJ: Damage control surgery for abdominal emergencies. Br J Surg. 2014, 101:109–18. 10.1002/bjs.9342CrossRef
68.
Atema JJ, Gans SL, Boermeester MA: Systematic review and meta-analysis of the open abdomen and temporary abdominal closure techniques in non-trauma patients. World J Surg 2014. [Epub ahead of print]
69.
Sartelli M, Catena F, Di Saverio S, Ansaloni L, Malangoni M, Moore EE, et al.: Current concept of abdominal sepsis: WSES position paper. World J Emerg Surg 2014, 9:22. 10.1186/1749-7922-9-22CrossRefPubMedCentralPubMed
70.
Perathoner A, Klaus A, Mühlmann G, Oberwalder M, Margreiter R, Kafka-Ritsch R: Damage control with abdominal vacuum therapy (VAC) to manage perforated diverticulitis with advanced generalized peritonitis – a proof of concept. Int J Colorectal Dis. 2010, 25:767–74. 10.1007/s00384-010-0887-8CrossRefPubMed
71.
Kafka-Ritsch R, Birkfellner F, Perathoner A, Raab H, Nehoda H, Pratschke J, et al.: Damage control surgery with abdominal vacuum and delayed bowel reconstruction in patients with perforated diverticulitis Hinchey III/IV. J Gastrointest Surg. 2012, 16:1915–22. 10.1007/s11605-012-1977-4CrossRefPubMed
72.
Ordoñez C, Sanchez A, Pineda J, Badiel M, Mesa R, Cardona U, et al.: Deferred primary anastomosis versus diversion in patients with severe secondary peritonitis managed with staged laparotomies. World J Surg. 2010, 34:169–76. 10.1007/s00268-009-0285-yCrossRefPubMedCentralPubMed
Metadata
Title
A proposal for a CT driven classification of left colon acute diverticulitis
Authors
Massimo Sartelli
Frederick A Moore
Luca Ansaloni
Salomone Di Saverio
Federico Coccolini
Ewen A Griffiths
Raul Coimbra
Ferdinando Agresta
Boris Sakakushev
Carlos A Ordoñez
Fikri M Abu-Zidan
Aleksandar Karamarkovic
Goran Augustin
David Costa Navarro
Jan Ulrych
Zaza Demetrashvili
Renato B Melo
Sanjay Marwah
Sanoop K Zachariah
Imtiaz Wani
Vishal G Shelat
Jae Il Kim
Michael McFarlane
Tadaja Pintar
Miran Rems
Miklosh Bala
Offir Ben-Ishay
Carlos Augusto Gomes
Mario Paulo Faro
Gerson Alves Pereira Jr
Marco Catani
Gianluca Baiocchi
Roberto Bini
Gabriele Anania
Ionut Negoi
Zurabs Kecbaja
Abdelkarim H Omari
Yunfeng Cui
Jakub Kenig
Norio Sato
Andras Vereczkei
Matej Skrovina
Koray Das
Giovanni Bellanova
Isidoro Di Carlo
Helmut A Segovia Lohse
Victor Kong
Kenneth Y Kok
Damien Massalou
Dmitry Smirnov
Mahir Gachabayov
Georgios Gkiokas
Athanasios Marinis
Charalampos Spyropoulos
Ioannis Nikolopoulos
Konstantinos Bouliaris
Jaan Tepp
Varut Lohsiriwat
Elif Çolak
Arda Isik
Daniel Rios-Cruz
Rodolfo Soto
Ashraf Abbas
Cristian Tranà
Emanuele Caproli
Darija Soldatenkova
Francesco Corcione
Diego Piazza
Fausto Catena
Publication date
01-12-2015
Publisher
BioMed Central
Published in
World Journal of Emergency Surgery / Issue 1/2015
Electronic ISSN: 1749-7922
DOI
https://doi.org/10.1186/1749-7922-10-3

Other articles of this Issue 1/2015

World Journal of Emergency Surgery 1/2015 Go to the issue

Research article

Factors affecting morbidity and mortality in traumatic colorectal injuries and reliability and validity of trauma scoring systems

Review

Acute appendicitis: proposal of a new comprehensive grading system based on clinical, imaging and laparoscopic findings

Commentary

Defining our destiny: trainee working group consensus statement on the future of emergency surgery training in the United Kingdom

Research article

Intra-abdominal hypertension; prevalence, incidence and outcomes in a low resource setting; a prospective observational study

Research article

The impact of early surgical intervention in free intestinal perforation: a time-to-intervention pilot study

Research article

Metallothionein ameliorates burn sepsis partly via activation of Akt signaling pathway in mice: a randomized animal study