Abstract
Thoracic foregut surgical emergencies, such as esophageal perforations and incarcerated hiatal hernias, can be challenging in geriatric patients. Untreated, these conditions are associated with high morbidity and mortality, yet surgical intervention and repair often involve complex procedures associated with high morbidity and mortality and/or loss of independence in geriatric patients. This chapter discusses the diagnosis and management of esophageal perforation and incarcerated hiatal hernias in the geriatric population, with special emphasis on minimally invasive and robotic surgical approaches.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Etzoni DA, Kiu JH, Maggard MA, Ko CY. The aging population and its impact on the surgery workforce. Ann Surg. 2003;238(2):170–7.
Mohanty S, Rosenthal RA, Russell MM, Neuman MD, Ko CY, Esnaola NF. Optimal preoperative management of the geriatric patient: a best practices guideline from the American College of Surgeons NSQIP and the American Geriatrics Society. J Am Coll Surg. 2016;222(5):930–47.
Torrance AD, Powell SL, Griffiths EA. Emergency surgery in the elderly: challenges and solutions. Open Access Emerg Med. 2015;7:55–68.
Merchea A, Cullinane DC, Saqyer MD, Iqbal CW, Baron TH, Wigle D, et al. Esophagogastroduodenoscopy-associated gastrointestinal perforations: a single-center experience. Surgery. 2010;148(4):876–80; discussion 881–2.
Zimmermann M, Hoffmann M, Jungbluth T, Bruch HP, Keck T, Schloericke E. Predictors of morbidity and mortality in esophageal perforation: retrospective study of 80 patients. Scand J Surg. 2017;106(2):126–32.
Browning KN, Travagli RA. Central nervous system control of gastrointestinal motility and secretion and modulation of gastrointestinal Etzoni DA, Kiu JH, Maggard MA, Ko CY. The aging population and its impact on the surgery workforce. Ann Surg. 2003;238(2):170–7.
Kuo B, Urma D. Esophagus—anatomy and development. GI Motility. 2006;
Ezenkwele UA, Long CM. Esophageal rupture and tears in emergency medicine treatment and management. Fortschr Med. 2016;
Kaman L, Iqbal J, Kundil B, Kochhar R. Management of esophageal perforation in adults. Gastroenterol Res. 2010;3(6):235–44.
Kallmeyer IJ, Collard CD, Fox JA, Body SC, Shernan SK. The safety of intraoperative transesophageal echocardiography: a case series of 7200 cardiac surgical patients. Anesth Analg. 2001;92(5):1126–30.
Pass LJ, LeNarz LA, Schreiber JT, Estrera AS. Management of esophageal gunshot wounds. Ann Thorac Surg. 1987;44(3):253–6.
Bolooki H, Anderson A, Garcia-Rivera C, Jude JR. Spontaneous rupture of the esophagus: Boerhaave’s syndrome. Ann Surg. 1971;174(2):319–24.
Campbell TC, Andrews JL, Neptune WB. Spontaneous rupture of the esophagus (Boerhaave syndrome): necessity of early diagnosis and treatment. JAMA. 1976;235(5):526–8.
Mackler SA. Spontaneous rupture of the esophagus; an experimental and clinical study. Surg Gynecol Obstat. 1952;95(3):345–56.
Vial CM, Whyte RI. Boerhaave’s syndrome: diagnosis and treatment. Surg Clin North Am. 2005;85(3):515–24. ix
Vogel SB, Rout WR, Martin TD, Abbitt PL. Esophageal perforation in adults: aggressive, conservative treatment lowers morbidity and mortality. Ann Surg. 2005;241(6):1016–23.
Soreide JA, Viste A. Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours. Scand J Trauma Resusc Emerg Med. 2011;19:66.
Raymond DP, Watson TJ. Esophageal diversion. Op Tech Thorac Cardiovasc Surg. 2008;13(2):138–46.
Gill RC, Pal KM, Mannan F, Bawa A, Gatimi SH. T-tube placement as a method for treating penetrating oesophageal injuries. Int J Surg Case Rep. 2016;28:255–7.
Kiernan PD, Rhee J, Collazo L, Hetrick VH, Vaughan B, Graling P. Complete esophageal diversion: a simplified, easily reversible technique. J Am Coll Surg. 2005;200(5):812.
Sharma P, Kozarek R. Role of esophageal stents in benign and malignant diseases. Am J Gastroenterol. 2010;105(2):258–73.
Biancari F, D’Andrea V, Paone R, Di Marco C, Savino G, Koivukangas V, et al. Current treatment and outcome of esophageal perforations in adults: systematic review and meta-analysis of 75 studies. World J Surg. 2013;37(5):1051–9.
Montecino-Rodriguez E, Berent-Maoz B, Dorshkind K. Causes, consequences, and reversal of immune system aging. J Clin Invest. 2013;123(2):958–65.
Liu HC, Chen CH, Chan ML, Chen CH, Huang WC. Management of esophageal perforations in elderly patients. Int J Gerontol. 2015;9(2):107–10.
Killinger LZ. Diagnostic challenges in the older patient. Chiropr Man Therap. 2012;20:28.
Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59(3):255–63.
Audisio RA, Pope D, Ramesh HS, Gennari R, van Leeuwen BL, West C, et al. Shall we operate? Preoperative assessment in elderly cancer patients (PACE) can help. A SIOG surgical task force prospective study. Crit Rev Oncol Hematol. 2008;65(2):156–63.
Alvarez-Nebreda ML, Bentov N, Urman RD, Setia S, Huang JC, Pfeifer K, et al. Recommendations for preoperative management of frailty from the Society for Perioperative Assessment and Quality Improvement (SPAQI). J Clin Anesth. 2018;47:33–42.
Pouwels S, Fiddelaers J, Teijink JA, Woorst JF, Siebenga J, Smeenk FW. Preoperative exercise therapy in lung surgery patients: a systematic review. Respir Med. 2015;109(12):1495–504.
Coats V, Maltais F, Simard S, Frechette E, Tremblay L, Riberio F, et al. Feasibility and effectiveness of a home-based exercise training program before lung resection surgery. Can Respir J. 2013;20(2):e10–6.
Weinstein H, Bates AT, Spaltro BE, Thaler HT, Steingart RM. Influence of preoperative exercise capacity on length of stay after thoracic cancer surgery. Ann Thorac Surg. 2007;84(1):197–202.
Sihag S, Rattner DW. Management of complicated and strangulated hiatal hernias. In: DiSaverio S, Catena F, Ansaloni L, Coccolini F, Velmahos G, editors. Acute care surgery handbook. Cham: Springer; 2017.
Davis SS Jr. Current controversies in paraesophageal hernia repair. Surg Clin North Am. 2008;88(5):959–78.
Kohn GP, Price RR, Demeester SR, Zehetner J, Muensterer OJ, Awad ZT, et al. Guidelines for the management of hiatal hernia. Surg Endosc. 2013;27(12):4409–28.
Low DE, Simchuk EJ. Effet of paraesophageal hernia repair on pulmonary function. Ann Thorac Surg. 2002;72(2):333–7.
Cardile AP, Heppner DS. Gastric volvulus, Borchardt’s triad, and endoscopy: a rare twist. Hawaii Med J. 2011;70(4):80–2.
Marcos SK. Review article: effects of radiographic contrast media on the lung. Br J Radiol. 2003;76(905):290–5.
Stylopoulous N, Gazelle GS, Rattner DW. Paraesophageal hernias: operation or observation? Ann Surg. 2002;236(4):492–500.
Hallissey MT, Ratliff DA, Temple JG. Paraoesophageal hiatus hernia: surgery for all ages. Ann R Coll Surg Engl. 1992;74(1):23–5.
Polomsky M, Jones CE, Sepesi B, O’Connor M, Matousek A, Hu R, et al. Should elective repair of intrathoracic stomach be encouraged? J Gastrointest Surg. 2010;14(2):203–10.
Awais O, Luketich JD. Management of giant paraesophageal hernia. Minerva Chir. 2009;64(2):159–68.
Bawahab M, Mitchell P, Church N, Debru E. Management of acute paraesophageal hernia. Surg Endosc. 2009;23(2):255–9.
Geha AS, Massad MG, Snow NJ, Baue AE. A 32-year experience in 100 patients with giant paraesophageal hernia: the case for abdominal approach and selective antireflux repair. Surgery. 2000;128(4):623–30.
Rumstadt B, Kahler G, Michkisch O, Schilling D. Gastric mesh erosion after hiatoplasty for recurrent paraesophageal hernia. Endoscopy. 2008;40(Suppl 2):E70.
Swanstrom LL, Marcus DR, Galloway GQ. Laparscopic Collis gastroplasty is the treatment of choice for the shortened esophagus. Am J Surg. 1996;171(5):477–81.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Koo, D.C., Angeles, C., Weigel, T.L. (2021). Esophageal Perforation and Incarcerated Hiatal Hernia in the Elderly. In: Latifi, R., Catena, F., Coccolini, F. (eds) Emergency General Surgery in Geriatrics . Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-030-62215-2_14
Download citation
DOI: https://doi.org/10.1007/978-3-030-62215-2_14
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-62214-5
Online ISBN: 978-3-030-62215-2
eBook Packages: MedicineMedicine (R0)