Anorectal emergencies: WSES-AAST guidelines

Antonio Tarasconi, Gennaro Perrone, Justin Davies, Raul Coimbra, Ernest Moore, Francesco Azzaroli, Hariscine Abongwa, Belinda De Simone, Gaetano Gallo, Giorgio Rossi, Fikri Abu-Zidan, Vanni Agnoletti, Gianluigi de’Angelis, Nicola de’Angelis, Luca Ansaloni, Gian Luca Baiocchi, Paolo Carcoforo, Marco Ceresoli, Alain Chichom-Mefire, Salomone Di SaverioFederica Gaiani, Mario Giuffrida, Andreas Hecker, Kenji Inaba, Michael Kelly, Andrew Kirkpatrick, Yoram Kluger, Ari Leppäniemi, Andrey Litvin, Carlos Ordoñez, Vittoria Pattonieri, Andrew Peitzman, Manos Pikoulis, Boris Sakakushev, Massimo Sartelli, Vishal Shelat, Edward Tan, Mario Testini, George Velmahos, Imtiaz Wani, Dieter Weber, Walter Biffl, Federico Coccolini, Fausto Catena

Research output: Contribution to journalReview articlepeer-review

24 Citations (Scopus)


Anorectal emergencies comprise a wide variety of diseases that share common symptoms, i.e., anorectal pain or bleeding and might require immediate management. While most of the underlying conditions do not need inpatient management, some of them could be life-threatening and need prompt recognition and treatment. It is well known that an incorrect diagnosis is frequent for anorectal diseases and that a delayed diagnosis is related to an impaired outcome. This paper aims to improve the knowledge and the awareness on this specific topic and to provide a useful tool for every physician dealing with anorectal emergencies. The present guidelines have been developed according to the GRADE methodology. To create these guidelines, a panel of experts was designed and charged by the boards of the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) to perform a systematic review of the available literature and to provide evidence-based statements with immediate practical application. All the statements were presented and discussed during the WSES-AAST-WJES Consensus Conference on Anorectal Emergencies, and for each statement, a consensus among the WSES-AAST panel of experts was reached. We structured our work into seven main topics to cover the entire management of patients with anorectal emergencies and to provide an up-to-date, easy-to-use tool that can help physicians and surgeons during the decision-making process.

Original languageEnglish
Article number48
JournalWorld Journal of Emergency Surgery
Issue number1
Publication statusPublished - Dec 2021


  • Angiography
  • Anorectal Varices
  • Anorectal bleeding
  • Anorectal foreign bodies
  • Anorectal sepsis
  • Antibiotics
  • Diagnosis
  • Embolization
  • Fournier’s gangrene
  • Guidelines
  • Hemorrhoids
  • Non-operative management
  • Surgery
  • Technique
  • Timing

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine


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