Pectus excavatum surgical correction

Case contributed by Assoc Prof Craig Hacking

Presentation

Post op CXR

Patient Data

Age: 30 years
Gender: Male

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.

X-ray

Pre op CXR

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%), hemothorax, 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 pediatric surgeon in Virginia.

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Case information

rID: 34976
Published: 15th Apr 2015
Last edited: 7th Sep 2020
Inclusion in quiz mode: Included

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