General Surgical Emergencies in Johannesburg

What it involves

Appendicectomy (usually laparoscopic), bowel obstruction, perforated peptic ulcer, incarcerated hernia, acute cholecystitis, and general surgical trauma. When you arrive in casualty, the on-call surgeon is contactable and involved from the outset.

Acute appendicitis is the most common emergency general-surgical operation. Classical presentation is central abdominal pain migrating to the right lower quadrant over 12–24 hours, with loss of appetite and low-grade fever. In children and older adults the presentation can be atypical, and ultrasound or CT is often used to confirm.

Bowel obstruction — from adhesions, hernias, or tumours — presents with colicky pain, vomiting, distension, and constipation. Some cases settle with a nasogastric tube and time; others need urgent surgery to prevent bowel strangulation and perforation.

An incarcerated hernia (one that won't push back in) or a strangulated hernia (with pain and colour change) is a surgical emergency. Delay risks bowel death. If a bulge in the groin or abdomen becomes suddenly painful and firm, go to casualty immediately.

When it's indicated

Severe or persistent abdominal pain, vomiting with distension, blood in the stool, or a hernia that has become suddenly painful and cannot be pushed back — go to casualty at JSH or your nearest emergency department.

The approach

Emergency surgery rewards preparation. The theatre team knows how Dr Marais operates and equipment for laparoscopic emergencies is set up in advance — decisions get made faster.

Recovery

Depends entirely on the operation. Laparoscopic appendicectomy: one to two nights, back to work in one to two weeks. Bowel resection: three to seven nights, four to six weeks off work. Every recovery plan is individualised in hospital.