OVERVIEW

Gastrointestinal emergencies refer to urgent medical conditions that affect the digestive system, which includes the oesophagus, stomach, intestines, liver, gallbladder, and pancreas. These emergencies require immediate medical attention and intervention due to their potentially life-threatening nature. Gastrointestinal emergencies include the following:

• Peptic ulcer disease: Peptic ulcer disease refers to the presence of open sores in the lining of either the stomach or the small intestine. It often results from infection with H. pylori bacteria or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). Symptoms include abdominal pain, indigestion, heartburn, and bleeding in severe cases.
• Cholecystitis: Cholecystitis refers to the inflammation of the gallbladder, typically resulting from the obstruction of the bile duct by gallstones. It leads to intense right upper abdominal pain, fever, nausea, and vomiting. Prompt medical intervention is necessary to prevent complications such as gallbladder rupture or infection.
• Diverticulitis: Diverticulitis occurs when small pouches (diverticula) in the colon become infected or inflamed. It results in abdominal pain (usually in the lower left side), fever, changes in bowel habits, and sometimes rectal bleeding. Treatment includes antibiotics, dietary modifications, and, in severe cases, surgery.
• Adhesive small bowel disease: Adhesive small bowel disease refers to the formation of scar tissue (adhesions) in the small intestine, often following abdominal surgery. These adhesions can cause intestinal blockage, leading to abdominal pain, vomiting, and distension. Surgical intervention may be necessary to relieve the obstruction.
• Appendicitis: Appendicitis is the inflammation of the appendix, a tiny pouch found in the lower right abdomen. It causes severe abdominal pain, especially in the right lower quadrant, along with fever, nausea, vomiting, and loss of appetite. Appendectomy (surgical removal of the appendix) is typically required.
• Sigmoid and intestinal volvulus: Volvulus occurs when a portion of the intestine twists abnormally, causing obstruction and compromising blood flow. Sigmoid volvulus affects the sigmoid colon. Symptoms include severe abdominal pain, distension, constipation, and vomiting. Emergency surgery is necessary to unravel the bowel and restore blood flow.

TREATMENT

Consultation with Dr Botes is necessary to determine the most appropriate surgical treatment for each case. Surgical treatments for the following gastrointestinal conditions are as follows:

• Gastrectomy: Surgical removal of part or all of the stomach, performed to treat conditions like stomach cancer, severe ulcers, or obesity-related issues.
• Cholecystectomy: Surgical removal of the gallbladder, typically performed to treat cholecystitis (inflammation) or gallstones causing symptoms.
• Segmental resection: Surgical removal of a segment of an organ, often used in conditions like diverticulitis or bowel cancer, to remove the affected portion while preserving healthy tissue.
• Appendectomy: Surgical removal of the appendix, commonly performed to treat appendicitis, an inflammation of the appendix.
• Sigmoid colectomy: Surgical resection of the sigmoid colon, usually performed in cases of sigmoid volvulus, diverticular disease, or certain types of colorectal cancer.