Presentation
Post op CXR
Patient Data
Nuss bar in situ with slight angulation (more superior on the left). There is a small apical pneumothorax on the right. The lungs are clear. Bilateral chest drains are present, and there is a small amount of chest wall emphysema.
Pre op CXR showing pectus excavatum deformity.
Case Discussion
The Nuss procedure for surgical correction of pectus excavatum involves passing a curved Nuss bar underneath the concave anterior chest wall. The bar is then rotated, to create and support a convex chest wall shape, before being sutured in place.
Complications of the procedure that radiologists need to be aware of include pneumothorax (up to 50%), hemothorax, pleural effusion, and fracture of migration of the Nuss bar.1 Pericarditis and pneumonia are uncommon. Since the procedure is performed with thoracoscopy, complications are usually avoided at the time of surgery or are minimal.
The procedure was first described by Dr. Donald Nuss in 1987, a US pediatric surgeon in Virginia.
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