The most common complications of inflammatory bowel disease (IBD) requiring emergency treatment are toxic colitis, perforation, toxic megacolon, bleeding, sepsis and intestinal occlusion [1]. Admittedly, our experience with these situations is limited. Our gastroenterologist treats about 50 patients with IBD and an incidence rate of 5-6 newly detected patients per year per 70 000 habitants in our area, which corresponds to the nationwide population-based study in Italy (Table 1) [2]. Whereas most of these patients are amenable to medical treatment, some of them sooner or later present with intestinal emergencies. Furthermore, septic, hemorrhagic or perforative complications may be the first clinical manifestations of IBD. A transfer of these patients to specialized centres may be hazardous. This contribution gives true insight into the surgical management of IBD emergencies in a peripheral hospital based on 7 years of experience.

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