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Pectus Excavatum
Mantosh S. Rattan, MD; Randy R. Richardson, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Funnel chest
          • Definitions

            • Deformity of chest wall characterized by sternal depression

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • 3D Optical Surface Imaging

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Treatment

                              Selected References

                              1. Daemen JHT et al: Optical imaging versus CT and plain radiography to quantify pectus severity: a systematic review and meta-analysis. J Thorac Dis. 12(4):1475-87, 2020
                              2. Rodríguez-Granillo GA et al: Preoperative multimodality imaging of pectus excavatum: state of the art review and call for standardization. Eur J Radiol. 117:140-8, 2019
                              3. Sesia SB et al: Standardized Haller and asymmetry index combined for a more accurate assessment of pectus excavatum. Ann Thorac Surg. 107(1):271-6, 2019
                              4. Abu-Tair T et al: Impact of pectus excavatum on cardiopulmonary function. Ann Thorac Surg. 105(2):455-60, 2018
                              5. Dore M et al: Advantages of cardiac magnetic resonance imaging for severe pectus excavatum assessment in children. Eur J Pediatr Surg. 28(1):34-8, 2018
                              6. Obermeyer RJ et al: The physiologic impact of pectus excavatum repair. Semin Pediatr Surg. 27(3):127-32, 2018
                              7. Sujka JA et al: Quantification of pectus excavatum: anatomic indices. Semin Pediatr Surg. 27(3):122-6, 2018
                              8. Abid I et al: Pectus excavatum: a review of diagnosis and current treatment options. J Am Osteopath Assoc. 117(2):106-13, 2017
                              9. Pilegaard H et al: Minimal invasive repair of pectus excavatum and carinatum. Thorac Surg Clin. 27(2):123-31, 2017
                              10. Fagelman KM et al: The depression index: an objective measure of the severity of pectus excavatum based on vertebral diameter, a morphometric correlate to patient size. J Pediatr Surg. 50(7):1130-3, 2015
                              11. Tandon A et al: The effect of right ventricular compression on cardiac function in pediatric pectus excavatum. J Cardiovasc Magn Reson. 16(Suppl 1): P250, 2014
                              12. Birkemeier KL et al: Limited, fast magnetic resonance imaging as an alternative for preoperative evaluation of pectus excavatum: a feasibility study. J Thorac Imaging. 27(6):393-7, 2012
                              13. Oezcan S et al: Pectus excavatum: echocardiography and cardiac MRI reveal frequent pericardial effusion and right-sided heart anomalies. Eur Heart J Cardiovasc Imaging. 13(8):673-9, 2012
                              14. Birkemeier KL et al: Breathe in... breathe out... stop breathing: does phase of respiration affect the Haller index in patients with pectus excavatum? AJR Am J Roentgenol. 197(5):W934-9, 2011
                              15. St Peter SD et al: A novel measure for pectus excavatum: the correction index. J Pediatr Surg. 46(12):2270-3, 2011
                              16. Saleh RS et al: Cardiovascular magnetic resonance in patients with pectus excavatum compared with normal controls. J Cardiovasc Magn Reson. 12:73, 2010
                              17. Fokin AA et al: Anatomical, histologic, and genetic characteristics of congenital chest wall deformities. Semin Thorac Cardiovasc Surg. 21(1):44-57, 2009
                              18. Fonkalsrud EW: 912 open pectus excavatum repairs: changing trends, lessons learned: one surgeon's experience. World J Surg. 33(2):180-90, 2009
                              19. Restrepo CS et al: Imaging appearances of the sternum and sternoclavicular joints. Radiographics. 29(3):839-59, 2009
                              20. Castellani C et al: Early complications of the Nuss procedure for pectus excavatum: a prospective study. Pediatr Surg Int. 24(6):659-66, 2008
                              21. Kelly RE Jr: Pectus excavatum: historical background, clinical picture, preoperative evaluation and criteria for operation. Semin Pediatr Surg. 17(3):181-93, 2008
                              22. Nuss D et al: Minimally invasive surgical correction of chest wall deformities in children (Nuss procedure). Adv Pediatr. 55:395-410, 2008
                              23. Williams AM et al: Pectus deformities of the anterior chest wall. Paediatr Respir Rev. 4(3):237-42, 2003
                              24. Sidden CR et al: Radiologic considerations in patients undergoing the Nuss procedure for correction of pectus excavatum. Pediatr Radiol. 31(6):429-34, 2001
                              25. Nuss D et al: A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg. 33(4):545-52, 1998
                              26. Takahashi K et al: Obliteration of the descending aortic interface in pectus excavatum: correlation with clockwise rotation of the heart. Radiology. 182(3):825-8, 1992
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Imaging

                                  • Top Differential Diagnoses

                                    • Clinical Issues

                                      TERMINOLOGY

                                      • Synonyms

                                        • Funnel chest
                                      • Definitions

                                        • Deformity of chest wall characterized by sternal depression

                                      IMAGING

                                      • General Features

                                        • Radiographic Findings

                                          • CT Findings

                                            • MR Findings

                                              • 3D Optical Surface Imaging

                                                DIFFERENTIAL DIAGNOSIS

                                                  PATHOLOGY

                                                  • General Features

                                                    CLINICAL ISSUES

                                                    • Presentation

                                                      • Demographics

                                                        • Treatment

                                                          Selected References

                                                          1. Daemen JHT et al: Optical imaging versus CT and plain radiography to quantify pectus severity: a systematic review and meta-analysis. J Thorac Dis. 12(4):1475-87, 2020
                                                          2. Rodríguez-Granillo GA et al: Preoperative multimodality imaging of pectus excavatum: state of the art review and call for standardization. Eur J Radiol. 117:140-8, 2019
                                                          3. Sesia SB et al: Standardized Haller and asymmetry index combined for a more accurate assessment of pectus excavatum. Ann Thorac Surg. 107(1):271-6, 2019
                                                          4. Abu-Tair T et al: Impact of pectus excavatum on cardiopulmonary function. Ann Thorac Surg. 105(2):455-60, 2018
                                                          5. Dore M et al: Advantages of cardiac magnetic resonance imaging for severe pectus excavatum assessment in children. Eur J Pediatr Surg. 28(1):34-8, 2018
                                                          6. Obermeyer RJ et al: The physiologic impact of pectus excavatum repair. Semin Pediatr Surg. 27(3):127-32, 2018
                                                          7. Sujka JA et al: Quantification of pectus excavatum: anatomic indices. Semin Pediatr Surg. 27(3):122-6, 2018
                                                          8. Abid I et al: Pectus excavatum: a review of diagnosis and current treatment options. J Am Osteopath Assoc. 117(2):106-13, 2017
                                                          9. Pilegaard H et al: Minimal invasive repair of pectus excavatum and carinatum. Thorac Surg Clin. 27(2):123-31, 2017
                                                          10. Fagelman KM et al: The depression index: an objective measure of the severity of pectus excavatum based on vertebral diameter, a morphometric correlate to patient size. J Pediatr Surg. 50(7):1130-3, 2015
                                                          11. Tandon A et al: The effect of right ventricular compression on cardiac function in pediatric pectus excavatum. J Cardiovasc Magn Reson. 16(Suppl 1): P250, 2014
                                                          12. Birkemeier KL et al: Limited, fast magnetic resonance imaging as an alternative for preoperative evaluation of pectus excavatum: a feasibility study. J Thorac Imaging. 27(6):393-7, 2012
                                                          13. Oezcan S et al: Pectus excavatum: echocardiography and cardiac MRI reveal frequent pericardial effusion and right-sided heart anomalies. Eur Heart J Cardiovasc Imaging. 13(8):673-9, 2012
                                                          14. Birkemeier KL et al: Breathe in... breathe out... stop breathing: does phase of respiration affect the Haller index in patients with pectus excavatum? AJR Am J Roentgenol. 197(5):W934-9, 2011
                                                          15. St Peter SD et al: A novel measure for pectus excavatum: the correction index. J Pediatr Surg. 46(12):2270-3, 2011
                                                          16. Saleh RS et al: Cardiovascular magnetic resonance in patients with pectus excavatum compared with normal controls. J Cardiovasc Magn Reson. 12:73, 2010
                                                          17. Fokin AA et al: Anatomical, histologic, and genetic characteristics of congenital chest wall deformities. Semin Thorac Cardiovasc Surg. 21(1):44-57, 2009
                                                          18. Fonkalsrud EW: 912 open pectus excavatum repairs: changing trends, lessons learned: one surgeon's experience. World J Surg. 33(2):180-90, 2009
                                                          19. Restrepo CS et al: Imaging appearances of the sternum and sternoclavicular joints. Radiographics. 29(3):839-59, 2009
                                                          20. Castellani C et al: Early complications of the Nuss procedure for pectus excavatum: a prospective study. Pediatr Surg Int. 24(6):659-66, 2008
                                                          21. Kelly RE Jr: Pectus excavatum: historical background, clinical picture, preoperative evaluation and criteria for operation. Semin Pediatr Surg. 17(3):181-93, 2008
                                                          22. Nuss D et al: Minimally invasive surgical correction of chest wall deformities in children (Nuss procedure). Adv Pediatr. 55:395-410, 2008
                                                          23. Williams AM et al: Pectus deformities of the anterior chest wall. Paediatr Respir Rev. 4(3):237-42, 2003
                                                          24. Sidden CR et al: Radiologic considerations in patients undergoing the Nuss procedure for correction of pectus excavatum. Pediatr Radiol. 31(6):429-34, 2001
                                                          25. Nuss D et al: A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg. 33(4):545-52, 1998
                                                          26. Takahashi K et al: Obliteration of the descending aortic interface in pectus excavatum: correlation with clockwise rotation of the heart. Radiology. 182(3):825-8, 1992