2024-05-07 13:46:36
Heinz Hoenig‘s condition is still critical: an infection has injured his esophagus. Now he needs a complicated operation. What risks does this entail?
The reason was a bacterial infection that caused a wound in the esophagus. That’s why the entire esophagus now has to be removed in a major operation. You can find out here how such an operation works and what risks it entails.
Injured esophagus: when does surgery need to be performed?
The esophagus – also called the esophagus – connects the mouth with the stomach. The hollow organ consists of muscles, nerves and connective tissue. The main reasons that require surgery are:
- Injuries caused by accidents
- Injuries caused by surgery (such as an endoscopy)
- Tears after prolonged severe vomiting or retching
- Tears caused by swallowing large chunks of food
If the esophagus is injured, air, stomach acid and food can leak out, which can lead to severe inflammation in the chest. Therefore an operation may be necessary.
Esophageal or stomach cancer as well as so-called motility disorders of the esophagus (restricted mobility of the organ) also require surgery. Parts of the esophagus or the entire organ are removed.
In the case of Heinz Hoenig, a bacterial infection is said to have caused the injury. According to his wife Annika Hoenig, the doctors don’t know where the infection came from.
Symptoms of esophageal injuries
Symptoms of a ruptured esophagus include chest and abdominal pain, vomiting, blood in the vomit, low blood pressure and fever.
Removal of the esophagus – these are the options
If the esophagus is surgically removed, it is called an esophagectomy. There are different types; The choice of surgical approach depends on the location and extent of the injury.
- Partial removal of the esophagus: If the injury is in the upper or middle part of the esophagus, the entire esophagus may not need to be removed. The surgeon then removes the damaged section and pulls the stomach slightly up into the chest. There it connects it again to the healthy part of the esophagus. This creates a so-called sleeve stomach.
- Removal of the entire esophagus: If a large part of the esophagus is damaged, the entire organ must be removed. Here, too, the surgeon uses the stomach as a new esophagus, pulling it up into the chest until he can connect it to the healthy part of the esophagus. In rare cases it is not possible to use the stomach to connect to the esophagus. Then part of the intestine must be used to replace the removed part of the esophagus.
- Esophagogastrectomy: The surgeon removes the upper part of the stomach and the injured part of the esophagus and then connects the healthy parts together. This is usually used for cancerous tumors in the transition area between the esophagus and stomach.
If you have esophageal or stomach cancer, the surgeon will also remove some of the nearby lymph nodes. This helps reduce the risk of the cancer coming back.
According to his wife, actor Heinz Hoenig’s bacterial infection has spread so much that the entire esophagus has to be removed in a major operation. However, the procedure is associated with a great risk, she reports.
Risks of esophageal surgery
An injury to the esophagus is a medical emergency. A surgical repair must therefore be carried out immediately. However, the procedure is very complicated and complications such as blood poisoning (sepsis), shock, inflammation of the middle membrane (mediastinitis) or respiratory failure can occur.
To prevent infection, the doctor will also administer a broad-spectrum antibiotic before the operation. But even with immediate treatment, the risk of death from a large-scale injury to the esophagus is very high.
And even after the operation has been completed, the patient still has to take a few things into account. During healing, artificial nutrition is provided using a gastric tube for several months. Afterwards, with the new connection between the esophagus and stomach, the patient can swallow and eat more or less normally again. However, from now on the food must be divided into several smaller meals because the gastric sleeve has a smaller capacity.