Learn About Pectus Excavatum

What is the definition of Pectus Excavatum?

Pectus excavatum is a medical term that describes an abnormal formation of the rib cage that gives the chest a caved-in or sunken appearance.

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What are the alternative names for Pectus Excavatum?

Funnel chest; Cobbler's chest; Sunken chest

What is some background information about Pectus Excavatum?

Pectus excavatum occurs in a baby who is developing in the womb. It can also develop in a baby after birth. The condition can be mild or severe.

Pectus excavatum is due to too much growth of the connective tissue that joins the ribs to the breastbone (sternum). This causes the sternum to grow inward. As a result, there is a depression in the chest over the sternum, which may appear quite deep.

If the condition is severe, the heart and lungs can be affected. Also, the way the chest looks may cause emotional stress for the child.

What are the causes of Pectus Excavatum?

The exact cause is unknown. Pectus excavatum occurs by itself. Or there may be a family history of the condition. Other medical problems linked with this condition include:

  • Marfan syndrome (connective tissue disease)
  • Noonan syndrome (disorder that causes many parts of the body to develop abnormally)
  • Poland syndrome (disorder that causes muscles to not develop fully or at all)
  • Rickets (softening and weakening of the bones)
  • Scoliosis (abnormal curving of the spine)
When should I contact a medical professional for Pectus Excavatum?

Contact your health care provider if you or your child has any of the following:

  • Chest pain
  • Trouble breathing
  • Feelings of depression or anger about the condition
  • Feeling tired, even when not being active
What should I expect during a doctor appointment?

Your provider will perform a physical examination. An infant with pectus excavatum may have other symptoms and signs that, when taken together, define a specific condition known as a syndrome.

The provider will also ask about medical history, such as:

  • When was the problem first noticed?
  • Is it getting better, worse, or staying the same?
  • Do other family members have an unusual-shaped chest?
  • What other symptoms are there?

Tests may be done to rule out suspected disorders. These tests may include:

  • Chromosome studies
  • Enzyme assays
  • Metabolic studies
  • X-rays
  • CT scan

Tests may also be done to find out how severely the lungs and heart are affected.

This condition can be surgically repaired. Surgery is generally advised if there are other health problems, such as trouble breathing. Surgery may also be done to improve the appearance of the chest. Talk to your provider about treatment options.

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What are the latest Pectus Excavatum Clinical Trials?
Comparison of Erector Spinae Plane and Paravertebral Nerve Blocks for Postoperative Analgesia in Children After the Nuss Procedure

Summary: This is a prospective randomized double-blind non-inferiority trial designed to test the hypothesis that erector spinae plane block (ESPB) is non-inferior to thoracic paravertebral block (TPVB) in postoperative pain control after pectus excavatum repair.

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The Use of Video-assisted Intercostal Nerve Cryoablation, Erector Spinae Block, and Thoracic Epidural for Postoperative Analgesia After Minimally Invasive Repair of Pectus Excavatum

Summary: Pectus excavatum is the most common chest wall deformity in children, accounting for 90% of all congenital chest wall deformities. It occurs in one to eight per 1000 live births. The severity of the pectus deformity may become more noticeable during pubertal growth spurs and repair is therefore usually performed in the teenage years. A common operative procedure to repair a pectus deformity is the...

What are the Latest Advances for Pectus Excavatum?
Chest Wall Deformities and Congenital Lung Lesions: What the General/Thoracic Surgeon Should Know.
Pushing the boundaries of minimally invasive repair of pectus excavatum: first experience with a 4-bar technique.
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Pectus excavatum, kyphoscoliosis associated with thoracolumbar spinal stenosis: a rare case report and literature review.
Who are the sources who wrote this article ?

Published Date: July 15, 2021
Published By: Mary C. Mancini, MD, PhD, Cardiothoracic Surgeon, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Boas SR. Skeletal diseases influencing pulmonary function. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 445.

Danielson PD, Colombani PM. Repair of pectus excavatum. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier Saunders; 2020:897-900.

Gottlieb LJ, Reid RR, Slidell MB. Pediatric chest and trunk defects. In: Rodriguez ED, Losee JE, Neligan PC, eds. Plastic Surgery: Volume 3: Craniofacial, Head and Neck Surgery and Pediatric Plastic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 40.