1. General Philosophy.- Section A: Before the Operation.- 2. The Acute Abdomen.- 3. Rational Diagnostic Procedures.- 4. Who Should Look After the "Acute Abdomen" and Where?.- 5. Optimizing the Patient.- 6. Pre-operative Antibiotics.- 7. Family, Ethics, Informed Consent and Medicolegal Considerations.- Section B: The Operation.- 8. The Incision.- 9. Abdominal Exploration: Finding What Is Wrong.- 10. Peritonitis: Contamination and Infection: Principles of Treatment.- 11. The Intestinal Anastomosis.- 12. Upper Gastrointestinal Hemorrhage.- 13. Perforated Peptic Ulcer.- 14. Acute Pancreatitis.- 15. Acute Cholecystitis.- 16. Acute Cholangitis.- 17. Small Bowel Obstruction.- 18. "Acute" Abdominal Wall Hernias.- 19. Acute Mesenteric Ischemia.- 20. Inflammatory Bowel Disease,.- 21. Colonic Obstruction.- 22. Acute Appendicitis.- 23. Acute Diverticulitis.- 24. Massive Rectal Bleeding.- 25. Gynecological Emergencies.- 26. Penetrating Abdominal Trauma.- 27. Blunt Abdominal Trauma.- 28. The Abdominal Compartment Syndrome.- 29. Abdominal Closure.- 30. Ruptured Abdominal Aneurysm.- Section C: After the Operation.- 31. Nutrition.- 32. Postoperative Antibiotics.- 33. Postoperative Care.- 34. Postoperative Ileus Versus Intestinal Obstruction -.- 35. Intra-abdominal Abscesses.- 36. Abdominal Wall Dehiscence.- 37. Re-laparotomies and Laparostomy for Infection.- 38. LIRS, SIRS, Sepsis, MODS and Tertiary Peritonitis.- 39. Anastomotic Leaks and Fistulas.- 40. Wound Management.- 41. The Role of Laparoscopy.- 42. In the Aftermath and the M & M Meeting.

ix Preface Smart surgeons learn from their own mistakes, smarter surgeons learn from mistakes of others, some never learn . . . You are a resident, overworked and constantly tired; sitting down with your mentor for a brief tutorial. What do you want to get out of these few minutes? To organize your thoughts and approaches to the particular problem; to learn how he -the weathered surgeon -"tackles it"; to grasp a few practical "recipes" or "goodies" and take home a message or two; to laugh a bit and unwind. This is also our goal in this book. We hope that you are not repelled or offended by the non-formal character of this book. This is how emergency abdominal surgery is taught best, by trial and error and repetitions, with emphasis on basics. This is not a "complete" textbook, nor is it a cookbook type manual or discussion of case studies; neither is it a collection of detailed lecture notes or exhaustive lists. Instead, it consists of a series of informal, uncensored, chats between experienced surgeons and their trainees. No percentages, series, elaborated figures or complicated algorithms are included; only a surgeon's narrative, explaining how "he does it" -based on his experience and state of the art knowledge of the literature. No references are included as it was our aim to put down nothing which has not been experienced, confirmed and practiced in our own hands.