Large Bowel Emergencies

Emergency large bowel surgery represents a major part of the general surgical emergency workload and it is known to carry an increased risk of morbidity and mortality. The complications of colorectal cancer and diverticular disease are the commonest indications for surgery. Moreover, also inflammatory bowel disease can present in the way of an acute surgical emergency. The disease site varies with the pathology, although the sigmoid colon is overall the commonest site of disease. Pathology requiring emergency large bowel surgery may present with large bowel perforation, large bowel obstruction or a combination of both. Age, advanced malignant disease and serious intraperitoneal sepsis adversely affect survival. Compared to elective surgery, mortality is five to eight times greater for patients undergoing emergency general surgery procedures.