Publication:

Inguinal hernia and diverticulosis in octogenarians: the role of connective tissue and aging: a short narrative review

Inguinal hernia and diverticulosis are highly prevalent conditions in older adults that significantly affect health expenditures and complications. Increasing evidence suggests that both diseases may share common age-related pathophysiological mechanisms, particularly alterations in connective tissue and collagen metabolism. These associations appear especially relevant in octogenarians. A narrative literature review was conducted using PubMed to identify studies addressing inguinal hernia, diverticulosis, diverticulitis, connective tissue alterations, collagen metabolism, and aging, with a focus on patients aged 80 years and older. Relevant epidemiological, clinical, registry-based, and experimental studies were synthesized. The study reveals that diverticulosis affects roughly 70% of individuals aged 80 and older, with a concerning 20% recurrence rate of diverticulitis leading to high complication and mortality rates following surgery. As age increases, the risk for inguinal hernia also rises, especially for emergency repairs. Evidence suggests a common underlying connective tissue disorder linking the two conditions, with patients undergoing colectomy for diverticulitis at higher risk for incisional hernia. This calls for personalized management strategies, particularly preoperative assessments for patients with diverticulosis. Inguinal hernia and diverticulosis present significant challenges for octogenarians, necessitating informed, tailored management approaches. The study emphasizes the link between age-related connective tissue changes and adverse health outcomes, advocating for individualized care strategies. Ongoing research is essential to refine management pathways and improve outcomes for aging patients.