Exam

Pectus Excavatum

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Pectus Excavatum, Funnel Breast, Trichterbrust

  • Epidemiology
  1. Incidence: 0.5 to 2%
  2. Gender predominance: Boys (3:1 ratio)
  • Causes
  1. Rickets
  2. Scurvy
  3. Marfan's Syndrome
  4. Occupationally acquired
    1. Example: Cobbler's Chest (shoe pressed against chest)
  • Associated Conditions
  1. Scoliosis
  2. Congenital Heart Disease
  3. Severe childhood Asthma
  • Pathophysiology
  1. Deformed lower costal cartilages
  2. Results in retraction of chest wall toward spine
    1. Inferior Sternum
    2. Xiphoid process
  • Signs
  1. Opposite of Pectus Carinatum
  2. Mild: Oval pit near infrasternal notch
  3. Severe: Sinking of entire lower Sternum
  • Complications
  1. Restrictive Lung Disease in severe cases
  • References
  1. Degowin (1987) Bedside Exam, Macmillan, p. 274
  2. Murray and Nadel (2000) Respiratory Medicine, p. 2364-6