Presentation on theme: "Pectus excavatum (PE). There is a large group of congenital abnormalities of the thoracic cage that manifest as deformities of the anterior chest wall."— Presentation transcript:
Pectus excavatum (PE) is the most common chest wall malformation and one of the most frequent major congenital anomalies. It approximately occurs in 1 in every 400 births, with a 4:1 male predominance.
In patients with PE, the sternum and adjacent chest wall are displaced posteriorly toward the spine, creating a depression of the anterior chest wall.
Pathogenesis The currently accepted etiologic theory is that excessive growth of the lower costalb cartilages (gristle)occurs that forces the sternum into a concave position. The reason for this overgrowth of costal cartilages, which frequently increases the severity of the deformity in the preschool-age child and again during the pubertal years, is currently unknown.
Symptoms Symptoms are infrequent during early childhood, apart from a shy awareness of the abnormality and a typical unwillingness to expose the chest while swimming or taking part in other social or athletic activities.
It is particularly important that this deformity be corrected, if possible, before the child starts school,because it may cause severe psychologica （ mental ） and emotional damage.
During early adolescence Easy fatigability Shortness of breath with mild exercise Decreased stamina Tachycardia （ bradycardia ）,and/or palpitations are common Pectus excavatum patients commonly try hard to keep up with their peers physically
The Nuss procedure Minimally invasive repair using a convex steel bar guided across the chest through a substernal tunnel and then twisted with a wrench to force the convex side anteriorly, which elevates the depressed sternum and deformed costal cartilages.
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