Surgical Emergencies

Peptic ulcers, bowel obstruction and appendicitis, are conditions that require immediate surgical intervention. Peptic ulcers are exposed sores that form within the stomach lining or at the entrance of the small intestine. The pain from peptic ulcers can be severe and cause blood in the stool, nausea, fatigue and trouble breathing. Bowel obstruction that occurs when there is a blockage in the large or small intestine is yet another condition that can be fatal. Sometimes faecal matter gets stuck in the intestine and is difficult to push out, but something other than this causing the obstruction is what doctors refer to as “bowel obstruction.” An intestinal blockage causes stomach pain, vomiting or nausea and, in some cases, diarrhoea when the bowel is blocked partially.

The appendix is a pouch-like appendage located on the right side of the lower abdomen and is prone to inflammation, causing appendicitis. Pain from appendicitis radiates from the navel and moves into the lower part of the stomach.

Urgent surgical procedures

Dr Boesack performs these surgical emergencies to treat peptic ulcers, bowel obstruction and appendicitis:

• Stomach ulcer surgery repairs any damage to the stomach lining as a result of a peptic ulcer. Surgeons perform stomach ulcer surgery through a laparotomy or less invasive laparoscopy and endoscopy. Through miniaturised surgical tools and visual guidance by means of a bite-sized camera, the surgeon can access and repair the ulcer to prevent further damage to the stomach lining. Another surgical procedure is a partial gastrectomy. A small section of the stomach is removed to access and remove a gastric ulcer that is extremely large and lies deep within the stomach tissue.
• Surgery to relieve a blockage in the bowel isn’t usually necessary when there is a partial obstruction, whereby some food and fluid can seep through. For a complete bowel obstruction, surgeons insert an expandable stent to dilate the intestinal passage. An endoscope is passed through the mouth, where a stent enters into the blocked site.
• Appendectomy is a procedure to remove an infected appendix. Removing the appendix can be done through a 5-10 cm incision at the time of a laparotomy. A laparoscope with a camera at its end is inserted into the abdomen to remove the appendix. Surgeons remove an infected appendix when it ruptures with its contents leaking into the stomach. Beforehand, any abscess needs to be emptied of its fluid.