Overview Perforation of the upper gastrointestinal (UGI) tract is a relatively common surgical emergency. Most cases are due to peptic ulceration, but other causes, although uncommon, may be challenging to diagnose and manage (e.g. oesophageal perforation). Perforation secondary to endoscopic…
The acute abdomen may be defined as ‘abdominal pain of non-traumatic origin with a maximum duration of 5 days’. There is a long list of causes ranging from the entirely benign, requiring no particular management other than reassurance, to the…
Introduction Organ transplantation has revolutionised the treatment of end-stage organ failure and is arguably one of the greatest medical advances of the last century. Practice in organ donation and transplantation continues to evolve as a result of remarkable innovations in…
The scale of medical error As surgeons, we are arguably practitioners of one of the most entitled, rewarded and rewarding occupations in the world. We are empowered to the completely legal action of putting a knife to work in a…
Introduction A neck mass is a common clinical presentation. Surgeons should be familiar with common causes, red flag symptoms and characteristic examination findings. A wide range of conditions can present with a neck mass and an exhaustive explanation of investigation…
Introduction A hernia is defined as an abnormal protrusion of a cavity’s contents through a weakness in the wall of the cavity, taking with it all the linings of the cavity, although these may be markedly attenuated. With any definition,…
INTRODUCTION Perioperative nutrition is a critical aspect of surgical care. Surgical teams should screen elective patients for existing malnutrition or risk of developing malnutrition postoperatively. Optimising macronutrient anabolism and correcting micronutrient deficiencies are important goals for elective and emergency surgical…
Introduction The incidence of death directly attributable to anaesthesia has decreased significantly over the last 60 years. In the 1950s, several studies demonstrated that the postoperative mortality solely associated with anaesthesia was approximately 1 in 2500, 1–3 but by 1987,…
Introduction Few patients do not survive an operation, but many will incur significant morbidity around the time of surgery. These adverse outcomes are considered together as perioperative risk . Patient assessment is the process of gathering information to determine the…
Introduction Emergency general surgery (EGS) is a core component of general surgical practice. The challenges of caring for such patients include time-sensitive conditions, additional morbidity and mortality commensurate with this particular patient population, frequent diagnostic uncertainty, unpredictability, and the irregular…