[What Must the (General/Abdominal) Surgeon Know about Novel and Current Aspects as Well as Trends in Interdisciplinary "Emergency Room" Divisions (Knowledge of the [General and Abdominal] Surgeon)].

Abstract

Based on 1) selective but relevant references from current subject-specific medical literature and 2) competent clinical experiences of the interdisciplinary, professional, and sectoral profile of emergency medicine specialists and general/abdominal surgeons, current contents and trends of emergency management with specific surgical relevance are to be outlined.Narrative review.In addition to acute inflammatory or tumour diseases of the GI tract (and neighbouring organs) including threatening or manifest perforation, adequate care of injured patients (by accidents, physical violence) as well as bleeding in abdominosurgical dimension belong to the general and abdominal surgery care profile in the emergency room. In case of emergency care, there is repeatedly an imbalance between the number and severity of the patients on one side and the available resources on the other side, due to considerable variations in case volume and range of patient's condition (extending from completely unaffected to vitally threatened patients). Beside the "classical" general and abdominosurgical clinical pictures and diseases, the surgical care spectrum extends increasingly to gunshot and stab wounds (penetrating injuries). While there are recommendations for traumatic injuries including the abdomen, in particular, for diagnostic, treatment and disposable personal resources, such standard care policy for general/abdominal surgery emergency patients does not exist. Standardisation of emergency diagnoses, registration and risk stratification based on existing findings (clinical, anatomical, radiological) as well as evidence-based clinical pathways and bundle of measures including the documentation of treatment results in a national register for quality assurance may lead to improvement in the care in general/abdominal surgery emergency patients.To fulfil adequately all the requirements in interdisciplinary emergency cases, stringent workflows, discipline-, finding- and diagnosis-related therapeutic standards, high and developing expertise of physicians and interprofessional collaboration are all essential. Clinical quality assurance with register-based documentation and periodic auditing may improve patient care.