Pectus excavatum sugical correction

Case contributed by Dr Craig Hacking

Presentation

Post op CXR

Patient Data

Age: 31
Gender: Male
Modality: X-ray

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

Modality: X-ray

Pre op CXR showing pectus excavatum deformity.

Case Discussion

The Nuss procedure for surgical correstion 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 sututed in place.

Complications of the procedure that radiologists need to be aware of include pneumothorax (up to 50%), haemothorax, pelural effsuion 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 paediatric surgeon in Virginia.

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Case Information

rID: 34976
Case created: 18th Mar 2015
Last edited: 3rd Sep 2015
Inclusion in quiz mode: Included

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