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Intestinal obstruction occurs when food and stool are not able to move freely along the gut. There are many possible reasons for intestinal obstruction including hernias, tumours, abdominal adhesions, volvulus (intestine twists around itself) and foreign objects. Intestinal obstruction is a common problem with a high mortality rate unless treated promptly. Delays and improper management can cause infection, intestinal tear (perforation), pain, and death from the infection. An accurate history and examination are essential to lead to the correct investigation and management. That means doing the complete job and not moving forward until this is adequately done.

Fibroids are benign tumours or growths of the uterus (myomas or leiomyomas) which are very common in women of reproductive age and tend to reduce in size after the menopause. They usually do not require treatment unless they cause symptoms. Symptoms of fibroids include prolonged heavy periods, abdominal distention, lower abdominal discomfort, or pain. Fibroids may cause pressure on other structures leading to such symptoms as urinary frequency and constipation.

An ectopic pregnancy is when a fertilised egg implants and grows outside the main cavity of the uterus, usually in one of the fallopian tubes. Unfortunately, the pregnancy cannot be saved and can cause significant health risks to the mother. Where not detected promptly, this can lead to severe harm, such as loss of a fallopian tube, resulting in potential reduced future fertility.

A cholecystectomy is a relatively common surgery to remove the gallbladder often as a treatment for symptomatic gallstones. Left untreated, these gallstones can block the flow of bile and can cause problems such as acute cholecystitis or acute pancreatitis. Like with any operation, a cholecystectomy does have risks, in particular, sepsis.

Sepsis can lead to a range of complications. Most critically, it is commonly fatal, particularly if the diagnosis is delayed, or in patients with other significant health problems. Early recognition and interventions as above will give patients the best chance of survival.

Acute kidney injury (AKI) is now the preferred term for what used to be called “acute renal failure”. It is defined by an acute change in kidney function determined either by changes in the serum creatinine or reduction in the urine output into the oliguria range.