- Jed G Nuchtern, MD, FACS, FAAP
Jed G Nuchtern, MD, FACS, FAAP
- Professor of Surgery, Pediatric Surgery Division
- Baylor College of Medicine
- Oscar H Mayer, MD
Oscar H Mayer, MD
- Associate Professor of Clinical Pediatrics, Pediatric Pulmonology
- University of Pennsylvania School of Medicine
Pectus carinatum is an uncommon deformity of the chest wall that presents during childhood, and usually worsens during adolescence. Most patients have no associated symptoms, and repair usually is for cosmetic indications.
The definition, clinical features, and management of pectus carinatum will be presented here. Pectus excavatum, which is the most common chest wall deformity and is characterized by depression of the sternum, is discussed separately. (See "Pectus excavatum: Etiology and evaluation" and "Pectus excavatum: Treatment".)
Pectus carinatum is a protrusion deformity of the anterior chest wall. The term is derived from the Latin phrase for "chest with keel". Other terms for the deformity include chicken breast, pigeon chest, pyramidal chest, thorax cuneiform, or sternal kyphosis. There are two main types of pectus carinatum deformity [1-3]:
Chondrogladiolar prominence — Chondrogladiolar prominence, also known as chicken breast or keel chest, is the most common type of deformity [2,4]. The middle and lower portions of the sternum protrude and arch forward. The costal cartilages are concave and usually symmetrically depressed, accentuating the sternal prominence. The deformity is asymmetric in 30 to 50 percent of cases [4,5]. Infrequently, patients can have a combined pectus carinatum on one side of the chest and pectus excavatum on the other .
Chondromanubrial prominence — Chondromanubrial prominence, also known as Pouter pigeon breast, is a more complex and substantially less common form of pectus carinatum deformity, representing about 5 percent of cases [6,7]. In this form, the upper portion of the sternum protrudes anteriorly, and the body of the sternum is deviated posteriorly. A final anterior deflection of the distal sternum gives the characteristic Z-shape to the sternum on a lateral view.
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- Chondrogladiolar prominence
- Chondromanubrial prominence
- CLINICAL FEATURES
- Natural history
- Associated abnormalities
- Physical examination
- Chest imaging
- Additional testing
- - Protocols
- - Outcomes
- - Timing of referral and intervention
- - Outcome
- SUMMARY AND RECOMMENDATIONS