Introduction While paediatric surgery has increasingly become the domain of the subspecialist paediatric surgeon, adult general surgeons are still often faced with the challenges of assessing and managing children with surgical emergencies. The unique differences between adults and children must…
Introduction Acute anorectal pathology constitutes a significant proportion of the general surgeon’s workload. The problems encountered range from the acute pain of thrombosed haemorrhoids and perianal sepsis to the management of anorectal bleeding, trauma and irreducible rectal prolapse. Effective management…
Introduction Colonic emergencies result from obstruction, inflammation/infection, perforation, haemorrhage or ischaemia. Herein we discuss aetiology, pathogenesis, presentation and management. Emergency compared with elective colon surgery is associated with a two- to threefold increase in mortality, hence interventions to convert an…
Acknowledgement The fifth edition of this chapter was written by Peter Lamb. We have retained much of the information, revising, and updating it as appropriate. We acknowledge the excellence of his work. Introduction Acute disease of the small bowel, from…
Introduction As a general surgeon it is important to be competent in the management of the common emergency presentations associated with calculous biliary disease as these patients comprise a significant component of the acute workload. In addition, recognising the patient…
Introduction A major audit of upper gastrointestinal (UGI) bleeding in the UK carried out over 20 years ago reported an incidence of 103 patients per 100 000 adults per year. There is a twofold increase in likelihood of requiring hospitalisation…
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…