​​​If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice via phone to on-call consultant/registrar.

This emergency criteria are not an exhaustive list of gastroenterological emergencies. Health professionals should refer to HealthPathways for more information.

  • Acute surgical syndrome suspected by:
    • ​Presence of shock or sepsis and abdominal pain (e.g. peritonitis, appendicitis cholecystitis, cholangitis, severe diverticulitis, gut infarction or bowel obstruction, incarcerated hernia)
    • Ruptured abdominal aortic aneurysm (AAA)
    • Ectopic pregnancy
    • Ovarian torsion
    • Testicular torsion
    • Urosepsis
    • Gynaecological sepsis
    • Bowel obstruction
    • Acute pancreatitis
  • Acute, severe colitis (e.g. Crohn's disease, ulcerative colitis or infectious) > 6 bloody bowel stools per 24 hours (Truelove and Witts criteria) with any of the following:
    • ​Temperature > 37.8°C
    • Pulse rate > 90 bpm
    • Haemoglobin < 105 g/L
    • Severe abdominal pain
    • Suspected abscess, perforation or megacolon​​​
  • Melaena or haematochezia, haematemesis or vomiting in large volume or with haemodynamic compromise
  • Suspected or known inflammatory bowel disease with symptoms suggestive of severe flare of known inflammatory bowel disease accompanied by fever, haemodynamic compromise, significant abdominal pain, suspected megacolon, perforation, bowel obstruction and/or abscess and unable to be controlled in the community
  • Suspected or known inflammatory bowel disease with concern for severe or complicated colitis (perforation, toxic mega colon, abscess, bowel obstruction) indicated by:
    • Fever​
    • Tachycardia
    • Hypotension
    • Significant abdominal pain/peritonism
    • Abscess (abdominal or perianal)
    • Acute severe colitis: patients with > 6 bloody bowel motions per 24 hours plus at least one of the following:
      • Temperature > 37.8◦C​
      • Pulse rate > 90 bpm
      • Haemoglobin < 105 gm/L
      • Raised inflammatory markers (erythrocyte sedimentation rate (ESR) > 30 mm/hr or
        C-reactive protein (CRP) > 30 mg/L)​​
  • Gastrostomy feeding tube problems with blocked or displaced gastrostomy in patients with nil oral route for nutrition or hydration
  • Cirrhosis with acute clinical decompensation event (e.g. encephalopathy, gastrointestinal bleeding or new onset ascites, especially if with pain, fever or other systemic symptoms)
  • Liver failure (bilirubin > 100, INR > 2.0) with clinical signs of decompensation
  • Cholangitis (pain, fever and jaundice)
  • Dysphagia with inability to tolerate oral intake
Current as at: Wednesday 31 January 2024
Contact page owner: System Purchasing