Emergencies and complications in gastroenterology

Acute conditions in gastroenterology are typically connected with high morbidity and mortality; an optimal therapy of these conditions demands a close cooperation between several disciplines, particularly gastroenterology and surgery. However, systematic data for a generalized approach to determine the optimal diagnostic procedures and therapy have so far not been available. The publication on hand tries to fill this gap by providing gastroenterologists and surgeons with recommendations for a rational multidisciplinary approach. Acute states are characterized by multifactorial etiological changes as well as polymorbidity, which have an adverse influence on diagnostic accuracy and effect of therapy. In this situation, endoscopic examination which enables a simultaneous therapeutical solution is of fundamental importance. However, endoscopy is an invasive method, and due to patients’ polymorbidity, endoscopic approaches are limited by their general clinical condition, particularly by cardiopulmonary compensation. In these cases, non-invasive diagnostic methods are called for, such as ultrasound, computer tomography (CT) or nuclear magnetic resonance imaging. Moreover, modifications of these methods, e. g. CT-enteroclysis or CT-colonography, provide very precise and immediate results that allow to adopt the optimal strategic method. These methods may in the future substitute endoscopic examinations. This publication has been especially compiled for gastroenterologists, endoscopists, surgeons, intensivists and physicians involved in the management of acute cases to help them determine the optimal therapy for their patients.