Perforations of the Upper Gastrointestinal Tract
Part of the
Updates in Surgery
book series (UPDATESSURG)
It is becoming more common for surgeons to manage obese patients in the acute setting with non-bariatric surgical emergencies. Obesity presents a diagnostic challenge for the acute care surgeon. Given the emergent need for intervention and the subsequently minimized opportunity for preoperative selection and optimization, obese patients requiring emergency surgery represent a complex patient population at high risk for perioperative morbidity.
There is nothing unique about perforations of the upper gastrointestinal tract in the obese population versus other patients but there are specific additional considerations that the acute care surgeon should be aware of. It is particularly important that obese patients requiring emergency surgery are managed by an anesthetist experienced in the care of the obese along with an experienced surgeon in order to minimize the operative time and the risk of complications.
Bariatric surgical expertise seems to favorably impact hospital length of stay and the application of more minimally invasive approaches in cases not routinely done laparoscopically.
KeywordsUpper gastrointestinal perforations Acute care surgery Obesity Bariatric surgery Minimally invasive surgery
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