Upper gastrointestinal emergencies

Emergency presentation of diseases of the upper gastrointestinal tract represents a significant proportion of the acute general surgical workload with gallstone disease representing only a slightly smaller burden than acute appendicitis. Peptic ulcer disease, gallstones and pancreatitis are the three most common emergency conditions of the supra-colic compartment and their initial management should be within the capabilities of all general surgeons who contribute to an emergency service. The clinician’s approach to all three conditions has undergone changes due to new pharmacological and technological advances, however a sound understanding of the clinical presentation and natural history remains essential to their safe management. This article will deal with practical aspects of dealing with these patients in the emergency setting.