Surgery Pathways

24 pathways

Work through 24 interactive surgery decision pathways — branching, guideline-grounded workflows that take you from presentation to assessment, risk stratification and management. Each pathway cites its source (NICE, ESC, AHA and specialty guidance), embeds the relevant calculators, and makes escalation and safety-netting explicit. For decision support only — apply clinical judgement and local protocols.

Acute Appendicitis

Alvarado score, investigation pathway, and management including laparoscopic appendicectomy

NICE / SCOAP guidelines
Acute Cholecystitis

Tokyo guidelines — severity grading, antibiotic selection, and timing of cholecystectomy

Tokyo Guidelines 2018
Small Bowel Obstruction

Assessment and management of SBO — conservative vs surgical decision

WSES / EAST guidelines
Abdominal Aortic Aneurysm

AAA screening, surveillance intervals, and elective vs emergency repair thresholds

NICE NG156 2020
Acute Limb Ischaemia

Rutherford classification and emergency management of acute limb ischaemia

ESVS 2019
Large Bowel Obstruction

CT-guided assessment distinguishing volvulus from malignant LBO — stenting vs emergency surgery

ASGBI / ACPGBI / WSES 2022
Acute Diverticulitis

Hinchey classification, CT-guided management, and percutaneous vs surgical approach to complicated diverticulitis

WSES 2020 / ASCRS guidelines
Perforated Peptic Ulcer

Erect CXR, CT confirmation, Taylor conservative method vs emergency laparoscopic repair of PPU

WSES / ESGE / NICE guidelines
Acute Mesenteric Ischaemia

CT angiography-guided diagnosis and revascularisation vs resection decision in acute mesenteric ischaemia

ESVS 2017 / WSES 2021
Necrotising Fasciitis

LRINEC score, emergency surgical debridement, and ICU management of necrotising soft tissue infection

IDSA 2014 / WSES 2018
Faecal Peritonitis

Faecal Peritonitis clinical pathway.

ASGBI; RCS — Best Practice
Acute Compartment Syndrome

Acute Compartment Syndrome clinical pathway.

BAPRAS; BOA; RCS — Best Practice
Acute Pancreatitis

BSG / IAP — diagnosis (2 of 3 criteria), Glasgow / APACHE-II severity, supportive care, ERCP for cholangitis, ICU for severe.

BSG 2018; IAP/APA 2013
Inguinal Hernia Management

Watch-and-wait vs surgical repair; recognise strangulation; open vs laparoscopic; mesh considerations.

European Hernia Society 2018; BHS
Anorectal Abscess

Recognise + classify (perianal, ischiorectal, intersphincteric, supralevator); urgent surgical drainage; antibiotics in selected; investigate fistula.

ACPGBI; ASCRS
Pilonidal Sinus Disease

Recognise acute abscess (drainage) + chronic sinus (excision options), prevent recurrence with hygiene + hair removal.

ACPGBI; BAUS
Bariatric Surgery Complications

Recognise early (leak, bleed, VTE) + late (dumping, hypoglycaemia, nutritional deficiency, internal hernia, marginal ulcer); refer specialist centre.

BOMSS; ASMBS
Post-Operative Ileus

Recognise vs SBO, exclude electrolyte / drug / infection causes, supportive care, ERAS prevention.

ERAS Society 2019
Surgical Site Infection

NICE NG125 — prevention bundle, classify (superficial/deep/organ-space), antibiotic stewardship, source control.

NICE NG125 (2019)
Perioperative Anticoagulant Management

Risk-balance bleeding vs thrombosis; warfarin bridging strategies; DOAC interruption; antiplatelet decisions.

ACCP 2018; BSH 2016; NICE NG89
Wound Dehiscence

Recognise superficial vs deep dehiscence (burst abdomen); cover bowel + immediate theatre; prevent + treat risk factors.

ACPGBI; BAPRAS
Anastomotic Leak

Recognise (especially day 5–7), CT diagnosis, source control (re-laparotomy / drainage / endoluminal), aggressive resuscitation.

ACPGBI; ESCP
Surgical VTE Prophylaxis

NICE NG89 — risk-stratify all surgical inpatients, mechanical + pharmacological prophylaxis, extended duration in selected.

NICE NG89 (2018)
Damage Control Laparotomy

Concept of staged surgery for severely unstable trauma / surgical patient — control bleeding + contamination, defer definitive repair, ICU resuscitation, planned re-look.

EAST 2017; NCEPOD