Cardiothoracic Surgery in the Caribbean

Abstract Introduction: Despite being one of the main vacation destinations in the world, health care in the Caribbean faces many difficulties. The challenges involved in these islands' medical care range from low-resource institutions to lack of specialized care. In the field of thoracic and cardiac surgery, many limitations exist, and these include the lack of access to cardiac surgery for many small islands and little governmental funding for minimally invasive approaches in thoracic surgery. Methods: Literature review was done using PubMed/MEDLINE and Google Scholar databases to identify articles describing the characteristics of thoracic and cardiac surgery departments on Caribbean islands. Articles on the history, current states of practice, and advances in cardiothoracic surgery in the Caribbean were reviewed. Results: Regardless of the middle to high-income profile of the Caribbean, there are significant differences in the speed of technological growth in cardiothoracic surgery from island to island, as well as disparities between the quality of care and resources. Many islands struggle to advance the field of cardiothoracic surgery both through lack of local cardiac surgery centers and limited financial funding for minimally invasive thoracic surgery. Conclusions: Cardiac and thoracic surgery in the Caribbean depend not only on the support from local government policies and proper distribution of healthcare budgets, but efforts by the surgeons themselves to change and improve institutional cultures. Although resource availability still remains a challenge, the Caribbean remains an important region that deserves special attention with regard to the unmet needs for long-term sustainability of chest surgery.

Postpolypectomy syndrome presenting with "microperforation" and pneumoperitoneum: conservative approach for a rare cause of acute abdominal pain / Síndrome pospolipectomía de presentación como "microperforación" y neumoperitoneo: abordaje conservador para una rara causa de dolor abdominal

Introducción. El Síndrome Pospolipectomía es una causa rara de dolor abdominal posterior a resecciones de pólipos por colonoscopia, cuyo caso, en ciertos pacientes se debe considerar el manejo conservador. Métodos. Se revisa la literatura sobre el síndrome en mención y se reporta un caso. Resultados. Nuestra paciente presentó con cuadro de dolor abdominal posterior a una polipectomía colonoscópica, tratado mediante un manejo conservador con base en los hallazgos clínicos, tomográficos y paraclínicos. Su recuperación fue favorable y no requirió intervenciones adicionales. Conclusiones. El manejo conservador con líquidos endovenosos, antibióticos y suspensión de vía oral puede ser una opción en pacientes con síndrome pospolipectomía incluso, en contexto de ¨micro-perforaciones¨ cuando no haya irritación peritoneal

Post-polypectomy syndrome is a rare cause of acute abdominal pain following colonoscopic polyp resections. Conservative treatment may be considered in selected patients. We present a literature review of Post-polypectomy syndrome and report a case and our experience with a young female who presented with an acute abdominal pain following a colonoscopic polypectomy. We selected a conservative approach based on clinical findings, lab tests and CT results; the patient had complete recovery and no additional intervention was required. Conservative treatment with IV fluids, nothing by mouth and antibiotics can be an alternative treatment plan for selected patients with mini-perforations presenting without peritoneal irritation