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T.E.A. Study: three-day ertapenem versus three-day Ampicillin-Sulbactam

Background Intra-abdominal infections are one of the most common infections encountered by a general surgeon. However, despite this prevalence, standardized guidelines outlining the proper use of antibiotic therapy are poorly defined due to a lack of clinical trials investigating the ideal duration of antibiotic treatment. The aim of this study is to compare the efficacy and safety ...

A prospective, multi centre, randomized clinical study to compare the efficacy and safety of Ertapenem 3 days versus Ampicillin - Sulbactam 3 days in the treatment of localized community acquired intra-abdominal infection. (T.E.A. Study: Three days Ertapenem vs three days Ampicillin-sulbactam)

Background The recommendations outlined in the latest guidelines published by the Surgical Infection Society (SIS) and the Infectious Disease Society of America (IDSA) regarding the proper duration of antibiotic therapy in patients with intra-abdominal infections are limited and non-specific. This ambiguity is due mainly to the lack of clinical trials on the topic of optimal ...


A voluminous radiopaque foreign body (7 cm in diameter bowl) in the rectum of a 45-year-old male patient was removed uneventfully by a transanal approach with an obstetric forceps.

A “Beehive” in the Abdomen

Federico Coccolini Fausto Catena Roberto Manfredi Luca Ansaloni A 22 years-old woman presenting with intestinal occlusion by a giant fecaloma. Fecal impaction is often misdiagnosed, especially in

The HAC Trial (Harmonic for Acute Cholecystitis) Study. Randomized, double-blind, controlled trial of Harmonic(H) versus Monopolar Diathermy (M) for laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) in adults

Background In the developmental stage of laparoscopic cholecystectomy (LC) it was considered 'unsafe' or 'technically difficult' to perform laparoscopic cholecystectomy for acute cholecystitis (AC). With increasing experience in laparoscopic surgery, a number of centers have reported on the use of laparoscopic cholecystectomy for acute cholecystitis, suggesting that it is ...

The ACTIVE (Acute Cholecystitis Trial Invasive Versus Endoscopic) study: Multicenter randomized, double-blind, controlled trial of laparoscopic (LC) versus open (LTC) surgery for acute cholecystitis (AC) in adults

participated in the design of the study and performed the statistical analysis. ADP, LD, Federico Coccolini conceived of the study, and participated in its design and coordination and helped to draft the

Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and ...

WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis

Kluger Ari Leppaniemi Luca Ansaloni Manne Andersson Federico Coccolini Raul Coimbra Kurinchi S. Gurusamy Fabio Cesare Campanile Walter Biffl Osvaldo Chiara Fred Moore Andrew B. Peitzman Gustavo P. Fraga ... , Fausto Catena, Massimo Sartelli Organization Committee members: Salomone Di Saverio, Fausto Catena, Micheal D. Kelly, Dieter Weber, Federico Coccolini, Massimo Sartelli, Luca Ansaloni, Ernest E Moore

WSES Guidelines for the management of acute left sided colonic diverticulitis in the emergency setting

Ansaloni Federico Coccolini Ewen A. Griffiths Fikri M. Abu-Zidan Salomone Di Saverio Jan Ulrych Yoram Kluger Ofir Ben-Ishay Frederick A. Moore Rao R. Ivatury Raul Coimbra Andrew B. Peitzman Ari Leppaniemi

Laparoscopic lavage versus resection in perforated diverticulitis with purulent peritonitis: a meta-analysis of randomized controlled trials

Objective Purulent peritonitis from acute left colon diverticulitis is a relatively common presentation of diverticular disease; historically the treatment was the Hartmann procedure. Laparoscopic peritoneal lavage has been proposed as a lesser invasive treatment option with great interest and debate among surgeons and with contrasting results. The aim of this meta-analysis was to ...

WSES classification and guidelines for liver trauma

The severity of liver injuries has been universally classified according to the American Association for the Surgery of Trauma (AAST) grading scale. In determining the optimal treatment strategy, however, the haemodynamic status and associated injuries should be considered. Thus the management of liver trauma is ultimately based on the anatomy of the injury and the physiology of ...

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

Coccolini 1 Ewen A Griffiths 6 Raul Coimbra 5 Ferdinando Agresta 4 Boris Sakakushev 9 Carlos A Ordoez 8 Fikri M Abu-Zidan 3 Aleksandar Karamarkovic 12 Goran Augustin 13 David Costa Navarro 10 Jan Ulrych 11

Benefits of WSES guidelines application for the management of intra-abdominal infections

Introduction The use of antibiotics is very high in the departments of Emergency and Trauma Surgery above all in the treatment of the intra-abdominal infections, to decrease morbidity and mortality rates; often the antimicrobial drugs are prescribed without a rationale and they are second-line antibiotics; this clinical practice increases costs without decreasing mortality. Aim of ...

One year experience of swine dermal non-crosslinked collagen prostheses for abdominal wall repairs in elective and emergency surgery

Introduction The approach to the abdominal wall surgical repair is dramatically changed in the last years. This study evaluates our institutional outcomes about the usage of biological meshes for abdominal wall repair in different setting: in elective surgery, in emergency surgery and in abdominal wall repair following open abdomen (OA) procedure. Methods A database was ...

The open abdomen, indications, management and definitive closure

The indications for Open Abdomen (OA) are generally all those situations in which is ongoing the development an intra-abdominal hypertension condition (IAH), in order to prevent the development of abdominal compartmental syndrome (ACS). In fact all those involved in care of a critically ill patient should in the first instance think how to prevent IAH and ACS. In case of ACS goal ...

The role of the open abdomen procedure in managing severe abdominal sepsis: WSES position paper

The open abdomen (OA) procedure is a significant surgical advance, as part of damage control techniques in severe abdominal trauma. Its application can be adapted to the advantage of patients with severe abdominal sepsis, however its precise role in these patients is still not clear. In severe abdominal sepsis the OA may allow early identification and draining of any residual ...

IROA: the International Register of Open Abdomen.: An international effort to better understand the open abdomen: call for participants

Actually the most common indications for Open Abdomen (OA) are trauma, abdominal sepsis, severe acute pancreatitis and more in general all those situations in which an intra-abdominal hypertension condition is present, in order to prevent the development of an abdominal compartment syndrome. The mortality and morbidity rate in patients undergone to OA procedures is still high. At ...

WSES guidelines for management of Clostridium difficile infection in surgical patients

In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary ...

Liver trauma: WSES position paper

The liver is the most injured organ in abdominal trauma. Road traffic crashes and antisocial, violent behavior account for the majority of liver injuries. The present position paper represents the position of the World Society of Emergency Surgery (WSES) about the management of liver injuries.