At this moment - just as you pick up this book and begin to browse through its pages - there are many thousands of surgeons around the world facing a patient with an abdominal catastrophe. The platform on which such an encounter occurs differs from place to place - be it a modern emergency department in Nepal, a shabby casualty room in the Bronx, or a doctor's tent in the African bush - but the scene itself is amazingly uniform. It is always the same: you confronting a patient, he - in pain, suffering and anxious. And you are anxious as well - anxious about the diagnosis,concerned about which is the best management, troubled about your own abilities to do what is correct. We are in the twenty-first century - but this universal scenario is not original. It is as old as surgery itself. You are perhaps too young to note how little things have changed over the years. Yes, your hospital may be in the forefront of modern medicine; its emergency room has standby, state-of-the-art spiral computed tomography and magnetic resonance imaging machines, but, practically, nothing has changed; it is the patient and you - you who are bound to provide a ccorrect management plan and execute it.