Pectus Excavatum

What is pectus excavatum?

Pectus excavatum is a condition where the bones of a child’s chest don’t develop properly during gestation, resulting in a sunken chest. Normally, the chest cage is made up of a center breast bone, ribs, and the spinal column.

In pectus excavatum, the breast bone is sunken or hollowed out. In some children, ribs may also appear deformed or uneven. 

There’s also a condition known as pectus carinatum, where the chest cage develops abnormally but instead causes a pigeon chest appearance due to the breast bone pushing outward.

Both conditions can worsen with age and, without treatment, can lead to deformities that interfere with mobility, breathing, and self-esteem.

How is pectus excavatum diagnosed?

When noticeable unevenness or deformities in the chest cage are present, your child’s pediatrician may recommend imaging tests, like a CT scan of the chest. The images provide information about the severity of the abnormalities in the breast bone and ribs.

Your child may also need lung function tests to assess if pectus excavatum or pectus carinatum interferes with their breathing.

How is pectus excavatum treated?

Treating pectus excavatum and pectus carinatum depends on the severity of your child’s condition. In mild cases, your pediatrician may recommend exercises to improve your child’s posture and strengthen their chest muscles.

When the abnormalities of pectus excavatum and pectus carinatum are moderate or severe, you may receive a referral to California Pediatric Surgical Group for surgery. The goal of surgery is to prevent a worsening of the chest deformity. Several surgical techniques are available to treat the chest cage, including:

Nuss procedure

The Nuss procedure involves inserting a steel bar that remains in place for 2-3 years to push out the breast bone.

Ravitch procedure

The Ravitch procedure involves removing ribs connected to the breast bone and straightening the breast bone.

Your California Pediatric Surgical Group surgeon determines the best course of surgical treatment based on your child’s age and the severity of their condition, and provides comprehensive care after surgery.

What happens after surgery for pectus excavatum?

Your child may need to limit activities that require twisting of the body for six months or longer after the surgery to allow the breast bone time to heal completely. Those undergoing a Nuss procedure also need to avoid any activities that could dislodge the steel bar from its position.

The surgical team at California Pediatric Surgical Group continues to monitor your child’s progress after surgery and can make recommendations for the right time to remove the bar following a Nuss procedure.

To schedule a consultation for pectus excavatum or pectus carinatum, call the California Pediatric Surgical Group nearest you or request an appointment online today.