Lower gastrointestinal emergencies and appendicitis

There is a general trend towards increasing numbers of emergency surgical admissions and a quarter of these are colonic. There are common themes in early management, resuscitation and investigation. The best outcomes are achieved with active conservative management, aggressive resuscitation and repeated assessment to measure response. If surgical intervention is required, preoperative investigation, to establish an accurate diagnosis, will ensure that appropriately skilled clinicians are involved in an expedient fashion to achieve the best outcomes.