Pectus excavatum

Case contributed by Dr Henry Knipe


Abdominal pain ?perforated viscus.

Patient Data

Age: 52
Gender: Female

Increased opacity in the medial right lower zone. Loss of right heart border and mild leftward mediastinal shift. 


Lateral projection demonstrates pectus excavatum, which accounts for frontal chest x-ray appearances. 

Case Discussion

Pectus excavatum is a common, congenital deformity of the anterior chest wall. It results in easily recognisable chest x-ray findings:

  • blurring of right heart border
  • increased density of the inferomedial lung zone
  • horizontal posterior ribs
  • vertical anterior ribs (heart shaped)
  • displacement of heart towards the left
  • obliteration of the descending aortic interface

Differential diagnosis includes:

  • right middle lobe consolidation/atelectasis
  • left para-aortic soft tissue density (e.g. mass)
  • mediastinal mass due to deformation of the cardiomediastinal contour
PlayAdd to Share

Case information

rID: 35171
Published: 25th Mar 2015
Last edited: 14th Aug 2019
System: Chest
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.