Pectus excavatum and its repair

Case contributed by Dr Ian Bickle

Presentation

Pectus excavatum clinically.

Patient Data

Age: 30 years
Gender: Female
X-ray

Heart shaped ribs.

The right heart border is not clearly delineated with the heart exclusively in the left side of the thoracic cavity.

Lungs clear.

 

3 years later

X-ray

Extensive thoracic cage metalwork including bars in keeping with a Nuss procedure.

Heart size normal.

Lungs clear.

Mild thoracic scoliosis.

Case Discussion

Several of the typical features of pectus excavatum are illustrated on the preoperative radiograph with blurring of right heart border and the heart being displaced to the left.

The most striking feature is the steep vertical orientation of the ribs giving a heart-shaped appearance to the thoracic cavity.  On the post surgical radiograph one can appreciate this has resolved.

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