Abdominal catastrophes and intestinal failure

Abstract

Defining an abdominal catastrophe is difficult, but the nature of colorectal surgery means that we encounter them regularly. Many relate to emergency surgery, anastomotic leakage or re-operative surgery, and most involve abdominal sepsis. Many will involve multiple organ failure, re-operation, bowel loss or damage, an open abdomen, multiple stomas or fistulae, nutritional dependence and prolonged debility. While simple cases may be readily managed, severe, complex and prolonged cases are not uncommon and pose greater challenges and a significant risk of death. Over the last 25 years, our institution has acted as a national referral centre for complex cases from around the UK and from Europe, and managed well over 1,000 cases. With experience, we have established principles of successful management, which will be discussed herein. © 2010 Springer-Verlag Berlin Heidelberg.