The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly

Paola Fugazzola, Marco Ceresoli, Federico Coccolini, Francesco Gabrielli, Alessandro Puzziello, Fabio Monzani, Bruno Amato, Gabriele Sganga, Massimo Sartelli, Francesco Menichetti, Gabriele Adolfo Puglisi, Dario Tartaglia, Paolo Carcoforo, Nicola Avenia, Yoram Kluger, Ciro Paolillo, Mauro Zago, Ari Leppäniemi, Matteo Tomasoni, Lorenzo CobianchiFrancesca Dal Mas, Mario Improta, Ernest E. Moore, Andrew B. Peitzman, Michael Sugrue, Vanni Agnoletti, Gustavo P. Fraga, Dieter G. Weber, Dimitrios Damaskos, Fikri M. Abu-Zidan, Imtiaz Wani, Andrew W. Kirkpatrick, Manos Pikoulis, Nikolaos Pararas, Edward Tan, Richard Ten Broek, Ronald V. Maier, R. Justin Davies, Jeffry Kashuk, Vishal G. Shelat, Alain Chicom Mefire, Goran Augustin, Stefano Magnone, Elia Poiasina, Belinda De Simone, Massimo Chiarugi, Walt Biffl, Gian Luca Baiocchi, Fausto Catena, Luca Ansaloni

Research output: Contribution to journalReview articlepeer-review

16 Citations (Scopus)


Acute left colonic diverticulitis (ALCD) in the elderly presents with unique epidemiological features when compared with younger patients. The clinical presentation is more nuanced in the elderly population, having higher in-hospital and postoperative mortality. Furthermore, geriatric comorbidities are a risk factor for complicated diverticulitis. Finally, elderly patients have a lower risk of recurrent episodes and, in case of recurrence, a lower probability of requiring urgent surgery than younger patients. The aim of the present work is to study age-related factors that may support a unique approach to the diagnosis and treatment of this problem in the elderly when compared with the WSES guidelines for the management of acute left-sided colonic diverticulitis. During the 1° Pisa Workshop of Acute Care & Trauma Surgery held in Pisa (Italy) in September 2019, with the collaboration of the World Society of Emergency Surgery (WSES), the Italian Society of Geriatric Surgery (SICG), the Italian Hospital Surgeons Association (ACOI), the Italian Emergency Surgery and Trauma Association (SICUT), the Academy of Emergency Medicine and Care (AcEMC) and the Italian Society of Surgical Pathophysiology (SIFIPAC), three panel members presented a number of statements developed for each of the four themes regarding the diagnosis and management of ALCD in older patients, formulated according to the GRADE approach, at a Consensus Conference where a panel of experts participated. The statements were subsequently debated, revised, and finally approved by the Consensus Conference attendees. The current paper is a summary report of the definitive guidelines statements on each of the following topics: diagnosis, management, surgical technique and antibiotic therapy.

Original languageEnglish
Article number5
JournalWorld Journal of Emergency Surgery
Issue number1
Publication statusPublished - Dec 2022


  • Acute diverticulitis
  • Elderly
  • Surgery in elderly

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine


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