⚠️ If the patient has unbearable abdominal pain, difficulty breathing, confusion, fainting, has vomited repeatedly, or is unable to stay hydrated or remain standing, please call 9-1-1 or go to the nearest emergency facility. You may request an ambulance or ask someone to drive you; if you feel very unwell, please do not drive yourself.
Take a deep breath. Here is what you should do
We understand that an emergency can be frightening. Many people are unsure how emergency services work in private hospitals, whether they may choose their surgeon, or what to say upon arrival. Below, we explain the process step by step.
1
Go to the Emergency Department at Clínica Bíblica
The Emergency Department is open 24 hours a day, 7 days a week, at all Clínica Bíblica locations. If possible, I recommend going directly to the San José Downtown location (Sede Central).
📍 Directions to the San José Downtown location
Hospital Clínica Bíblica · Calle Central (Alfredo Volio), between Avenues 14 and 16, San José, Costa Rica.
Upon arrival, specifically request an evaluation by Dr. Isabel Arce
What to say at the Emergency Department
“I am here for an abdominal emergency and I would like to be evaluated by Dr. Isabel Arce, surgical specialist.”
In Spanish, you may show this to the staff:“Vengo por una emergencia abdominal y quiero que me valore la Dra. Isabel Arce, especialista en cirugía.”
3
The emergency team will contact me directly
The emergency physician will perform the initial assessment and contact me directly. I will then evaluate you and calmly explain your diagnosis, the available options, and the next steps.
4
Bring the essentials and do not eat or drink anything
Bring a form of identification, a list of the medications you take, and any recent ultrasound or test results. While you wait, please do not eat or drink anything: if you require surgery, your stomach must be empty for anesthesia. If you have already eaten or had something to drink, that is not a problem: simply inform the medical team.
Do you have questions or are you unsure whether this is an emergency? Please write to us. However, if the pain is severe or the patient’s condition worsens, go directly to the Emergency Department.
AppendicitisPain that usually begins around the navel and moves down to the lower right side of the abdomen. It worsens with walking or coughing and may be accompanied by nausea and loss of appetite.Inflamed gallbladderSevere pain in the upper right abdomen, below the ribs, lasting more than 5–6 hours; it may also present with nausea, vomiting, or fever. Read more (in Spanish) →Complicated herniaA bulge in the groin or navel that previously went back in when lying down but no longer does; the hernia appears tense, is painful, and may change color. Read more (in Spanish) →Bowel obstructionThe abdomen may appear very distended (swollen), with frequent vomiting that may even resemble stool, intense cramping pain, and difficulty passing gas or having a bowel movement.Intestinal perforationSevere abdominal pain that is not relieved by anything; it may be accompanied by vomiting and fever. The patient may become very ill within a few hours. This is commonly referred to as “peritonitis.”
⚠️ In a surgical emergency, every minute counts. Seeking care early can often save a life. It may also mean a simpler procedure, smaller incisions, and a faster recovery.
Frequently asked questions
If the situation is very serious, call 9-1-1 or go to the nearest emergency facility. If you are able to travel safely and would like to be treated at a private hospital, go to the Emergency Department at Clínica Bíblica and specifically request an evaluation by Dr. Isabel Arce. The emergency team will contact me directly.
Yes. At a private hospital, you may request an evaluation by a specific surgeon. It is important to mention this upon arrival so that the emergency team can take it into account from the start.
Upon arrival at the Clínica Bíblica Emergency Department, say: “I would like to be evaluated by Dr. Isabel Arce, surgical specialist.” You may also repeat this to the emergency physician when you are seen.
You are welcome to write to us with any questions, and we will do our best to respond with the urgency your case requires. However, WhatsApp does not replace an in-person evaluation. If the pain is severe or the patient’s condition is worsening quickly, please go directly to the Emergency Department.
The decision of where to receive care is yours. If you prefer to have surgery at a private hospital, please discuss it with the physician currently treating you, so that they can explain whether a transfer is safe and how it can be arranged. If you are told that your condition is unstable, the safest course is not to be transferred until you are stable or until a hospital-to-hospital transfer has been coordinated.
The cost depends on the type of surgery, the length of the hospital stay, and medical fees. In emergencies, private hospitals usually request an initial deposit or pre-authorization from a private insurance provider. You may write to us to request a cost estimate for your case.
Most private health insurance plans cover emergencies and emergency surgery. Please bring your identification to the hospital’s insurance department, where the staff will assist you with the necessary paperwork so that you can focus on your recovery.
It is best not to. If you require surgery, your stomach must be empty for anesthesia to be administered safely. If you have already eaten, please do not worry: simply inform the medical team.
Ideally, avoid self-medicating, as some medications can mask symptoms and make the diagnosis more difficult. If you have already taken something, please mention it upon arrival.
Seek care immediately if the pain is severe, lasts several hours, or worsens, or if it is accompanied by fever, persistent vomiting, yellowing of the skin or eyes, a very hard and swollen abdomen, or an inability to pass gas. When in doubt, it is always better to be evaluated.
No. In emergencies, it is not necessary to schedule an appointment at my private office. Care is provided at the Emergency Department.
In many cases, yes. Appendicitis, an inflamed gallbladder, and some cases of intestinal obstruction or perforation can be treated laparoscopically, with incisions smaller than 1 cm, less pain, and a faster recovery. In other cases, this approach is not possible and a larger incision is required. The technique depends on each individual case, and your safety is always my priority.
In an emergency, you may go to any hospital in the country, as all hospitals are required to provide medical care. If you are in San José or are able to travel, please go to the Clínica Bíblica Emergency Department with your passport and your insurance information, and request an evaluation by Dr. Isabel Arce. The hospital’s insurance department will assist you in coordinating with your insurer.
If the emergency is serious, go to the nearest hospital: your safety comes first. If you are stable and able to travel, you may come to the Clínica Bíblica Emergency Department and request an evaluation by Dr. Isabel Arce.
I hold surgical privileges at all Clínica Bíblica locations and at Hospital CIMA. If you are at either of these hospitals, please request an evaluation by Dr. Isabel Arce at the Emergency Department. I am currently expanding my services to be included at Hospital Metropolitano.
Dr. Isabel Arce
General surgeon specializing in minimally invasive and robotic surgery. Graduated with honors from the University of Costa Rica. Clinical rotations at Harvard Medical School–affiliated hospitals and studies in clinical research at the Harvard T.H. Chan School of Public Health. Credentialed at Clínica Bíblica and Hospital CIMA. The first robotic surgeon in Costa Rica.
This article is for informational purposes only and does not replace a medical evaluation. In a serious emergency, call 9-1-1.
