Table 1 Summary of topics and PICO questions
From: WSES-AAST guidelines: management of inflammatory bowel disease in the emergency setting
| Topic | Question | Combination of words |
|---|---|---|
| Initial assessment and Diagnosis | Q.1: In patients with suspected complicated IBD, which are the appropriate biochemical investigations that should be performed? | “Crohn”, “Ulcerative colitis”, “abdominal pain”, “emergency”, “biochemical”, “laboratory”, “markers”, “investigation”; “test”; “metabolic panel” |
| Initial assessment and Diagnosis | Q.2: In patients with a suspected complicated IBD, which are the appropriate imaging studies that should be performed in the emergency setting? | “Crohn”; “Ulcerative colitis”; “emergency”; “radiology”; “computed tomography”; magnetic resonance”; ultrasonography”; “peritonitis”; abscess”; “occlusion” |
| Non operative management and preoperative assessment | Q.3: Which is the role of interventional radiology in the management of intra-abdominal abscesses related to Crohn’s disease in the emergency setting? | “Crohn"; “abscess”; “stricture”; “drainage”; “antibiotics”; “surgery”; “emergency”; “ulcerative colitis” |
| Preoperative management |
Q.4: In patients presenting with complications related to IBD, what is the appropriate medical treatment and nutritional support? -The role of medical treatment and management of specific IBD drugs -The role of nutritional support | “Crohn”; "Ulcerative Colitis"; Nutritional support”; “immunosuppression”; “steroids”; “biologics”; “medical treatment” antibiotics”; “emergency”; “preoperative”; “postoperative”; “surgery” |
|
Non-operative vs Operative management Clinical setting: -Acute severe ulcerative colitis; -Toxic megacolon; -Uncontrolled bleeding; -Free perforation; -Intestinal obstruction | Q.5: What are the indications for emergency surgery in patients presenting with complications related to IBD? | “Crohn”; "ulcerative colitis”; “toxic megacolon”; “upper gastrointestinal bleeding”;”peritonitis”; “perforation”; “occlusion”; “obstruction”;”emergency”; “surgery”; “indications”;”radiolology”;”angio-embolisation”; “computed tomography”;”angiography”, "lower gastrointestinal bleeding", "non operative management" |
| Surgical management | Q.6: Which surgical approach is recommended for complicated IBD in the emergency setting? | “Acute severe ulcerative colitis”; “intestinal bleeding”;”hemorrage”;“Crohn”; “anastomosis”; “laparoscopy”; “open”; “non operative management”; peritonitis”; “occlusion”; “perforation”; “toxic megacolon”; minimally invasive tecnique”; “emergency”;”damage control”;”open abdomen” |
| Surgical management | Q.7: How to manage perianal sepsis in the emergency setting? | “perianal”; “abscess”; “fistula”; “sepsis”;”antimicrobial”; “medical treatment”; “surgery”;”emergency”, "Crohn" |