[Visceral surgery in mass casualty incidents due to disasters, crises and war]

Mass casualty incidents with a focus on visceral surgery pose major medical and organizational challenges for hospitals. They are characterized by a large number of simultaneously admitted patients, limited personnel and material resources as well as the necessity to make time-critical surgical decisions. From a visceral surgical perspective, abdominal injuries involving severe bleeding, contamination and multiorgan involvement are particularly demanding as they require rapid surgical intervention and close interdisciplinary cooperation. This injury pattern is typically encountered in current terror situations, conflicts and wars and is therefore the foundation of the preparations for national and alliance defence.

The article outlines the surgical, ethical, organizational and structural requirements for visceral surgical care in mass casualty incidents.

Based on a structured analysis of the literature, a narrative review was performed, focusing on disaster medicine, surgical triage, damage control surgery and organizational aspects of surgical crisis management.

Key prerequisites for successful management include a consistent and dynamic surgical triage, damage control-oriented surgical strategies, resilient clinical structures and transparent medical ethical decision-making processes. Furthermore, standardized leadership and communication structures, interdisciplinary collaboration and regular realistic training are essential.

Effective visceral surgical mangement during mass casualty incidents or demanding situations over an indefinite time period due to conflicts or war requires not only surgical expertise but also crisis management skills, organizational resilience and structured decision-making processes. A systematic preparation through standardized concepts and regular training is essential for sustainable surgical disaster preparedness.