ABSTRACT
Penetrating injury to the great vessels in the thorax is an increasingly common and alarming clinical scenario in the West Indies, and in Jamaica in particular. The management of these often life-threatening injuries involves careful surgical planning and prompt operation, with close adherence to the principles of adequate pre-operative stabilization and investigations, and intra-operative exposure and repair. While this may be more easily accomplished in tertiary care centres, the geographical realities of the West Indies require that every surgeon be familiar with these techniques. A report of the management of some recent cases is followed by a review of the subject and recommended treatment strategies are outlined.
Subject(s)
Adult , Humans , Male , Middle Aged , Adolescent , Arteries/injuries , Thoracic Injuries/surgery , Wounds, Penetrating/surgery , Thoracic Injuries/diagnosis , Time Factors , Vascular Surgical Procedures , West Indies , Wounds, Penetrating/diagnosis , Emergency Medical Services , JamaicaABSTRACT
Etopia cordis is a rare congenital abnormality affecting the heart which is present either totally or partially outside the thorax. Because of associated cardiac defects, survival beyond birth is uncommon. One such case in whom death occurred on the 23rd post-operative day from heart failure is described and the management and ethical considerations discussed. This is the first case which has survived beyond birth in Jamaica.