Emergency general surgeons are frequently required to manage some of the most challenging conditions in abdominal surgery, often in unstable patients and time-critical circumstances. Sound judgement, adaptability, and familiarity with a range of operative strategies are essential to achieving the best possible outcomes. This session will explore three demanding areas of emergency practice: surgery for severe inflammatory bowel disease, management of colonic obstruction and perforation, and approaches to the open or difficult-to-close abdomen. Speakers will focus on practical decision-making, operative planning, and strategies to manage complications in high-risk patients. Designed for emergency general and colorectal surgeons, this session aims to provide clear, experience-based guidance for complex cases encountered on call.