esophageal tear

April 13, 2008 4:07 AM

My 70 year old father has been in ICU for 3 weeks now with no food or water because of a tear in his esophagus. Doctors are "stumped" and after 6 barium tests, can only repeat "it looks like it may heal itself." Any personal experiences or knowledge on this subject will be appreciated!!

FYI: he hasn't had a drink in 27 years. He has, however, in the last 4 years, consumed an average of 30+ Red Bulls a week. Aside from having a quadruple bypass 13 years ago, he hasn't had any major health concerns. Again, thanks in advance.

posted by camfys to health & fitness (5 comments total)

Well most likely, they are giving him some sort of nutrition. Either via nasogastric tube bypassing the esophageal tear directly to the stomach or via PEG tube. So your father is getting nutrition. He will be getting fluids via IV. While it be strange not to see him eat/drink for weeks, his nutritional status is likely well watched.

I would ask the doctors for 1) an exact diagnosis and 2) a definite plan. Also, I would think about getting a second opinion from either a gastroenterologist or bariatric surgeon.

Note: there may be (likely are) a million other things going on that I don't know about, so I would not be comfortable even thinking of a diagnosis for your father.
posted by ruwan at 4:27 AM on April 13, 2008

Google help
posted by i_am_a_Jedi at 5:45 AM on April 13, 2008

This just happened to a friend of mine. He was in the hospital for three weeks and is bloging about his experience. He was just released, but still can't eat. His injury was caused by sword swallowing.
The Misadventures of Rex Libris
posted by princelyfox at 7:07 AM on April 13, 2008 [2 favorites has favorites]

"I would ask the doctors for 1) an exact diagnosis and 2) a definite plan. Also, I would think about getting a second opinion from either a gastroenterologist or bariatric surgeon."

Seconding this. Knowing it's a tear and "stumped" seem to conflict with each other. What are they stumped about?
posted by gjc at 7:33 PM on April 13, 2008

Talk to the nurses and find out when the doctors generally round the ICU. Be there at that time. It probably won't be an exact time - it will be something like 5AM to 10AM or 8AM to 12PM then be there. This is the easiest time to talk to them. The doctors see many patients and that's why the time is not exact, but they see them all daily.

His labs are monitored daily. You can ask the nurses for a print out and then ask them what the values mean. He's probably hooked up to an IV and that is how his fluids, electrolytes, blood products are given when needed. There's a lot of routes his medical team could be considering, or be in the process of going: examples would be a feeding tube that would come out of his abdomen or putting in a central line where he got parenteral nutrition (TPN). There's a lot to consider before putting in a feeding tube or central line to assist feeding.

There is a great risk of feeding anyone water or food through their mouth if they are at risk of aspirating that substance into the lungs. That could make matters much much complicated. I don't want to be scary - but often the best course of action is time - frustrating as that may be. Ultimately you need to ask his medical team. Ask them why they think it will heal itself. Do they see some evidence towards that?

Does the hospital have a patient advocacy program? This is a department that assist communication between the family and the medical team. They can be a great resource for you. It's not everywhere but if it's at your Dad's hospital use it.

Good luck and take care.
posted by dog food sugar at 6:34 AM on April 14, 2008