Pectus carinatum, otherwise known as a pigeon chest, refers to a chest wall deformity in which the sternum protrudes anteriorly. It is less common than pectus excavatum.
Patients may present with dyspnoea and exercise intolerance.
- scoliosis (common) 2
- cyanotic congenital heart disease (uncommon)
- familial occurence is reported in ~25%.
A pectus carinatum may be demonstrated on lateral chest radiographs or cross-sectional imaging of the chest. There are two patterns of sternal protrusion:
- chondrogladiolar: protrusion of the middle and lower sternum
- chondromanubrial: protrusion of the manubrium and upper sternum (less common); known as Currarino-Silverman syndrome
Treatment and prognosis
Treatment options include non-surgical external bracing, typically for adolescents 5. Surgical repair usually results in symptomatic improvement 3 with a variety of techniques include open Ravitch procedure, open or thoracoscopic minimal cartilage resection or the reverse Nuss procedure with success rates of ~90% (range 67-100%) 5.
History and etymology
Carina is Latin for keel (as in the hull of a ship) 6.
- 1. Jeung MY, Gangi A, Gasser B et-al. Imaging of chest wall disorders. Radiographics. 19 (3): 617-37. Radiographics (full text) - Pubmed citation
- 2. Restrepo CS, Martinez S, Lemos DF et-al. Imaging appearances of the sternum and sternoclavicular joints. Radiographics. 29 (3): 839-59. doi:10.1148/rg.293055136 - Pubmed citation
- 3. Fonkalsrud EW, Beanes S. Surgical management of pectus carinatum: 30 years' experience. World J Surg. 2001;25 (7): 898-903. World J Surg (link) - Pubmed citation
- 4. Chidambaram B, Mehta AV. Currarino-Silverman syndrome (pectus carinatum type 2 deformity) and mitral valve disease. Chest. 1992;102 (3): 780-2. doi:10.1378/chest.102.3.780 - Pubmed citation
- 5. Emil S, Laberge JM, Sigalet D et-al. Pectus carinatum treatment in Canada: current practices. J. Pediatr. Surg. 2012;47 (5): 862-6. doi:10.1016/j.jpedsurg.2012.01.035 - Pubmed citation
- 6. http://www.dictionary.com/browse/carina