Pectus Excavatum

Aka: Pectus Excavatum, Funnel Breast, Trichterbrust

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II. Epidemiology

  1. Incidence: 0.5 to 2%
  2. Gender predominance: Boys (3:1 ratio)

III. Causes

  1. Rickets
  2. Scurvy
  3. Marfan's Syndrome
  4. Occupationally acquired
    1. Example: Cobbler's Chest (shoe pressed against chest)

IV. Associated Conditions

  1. Scoliosis
  2. Congenital Heart Disease
  3. Severe childhood Asthma

V. Pathophysiology

  1. Deformed lower costal cartilages
  2. Results in retraction of chest wall toward spine
    1. Inferior Sternum
    2. Xiphoid process

VI. Signs

  1. Opposite of Pectus Carinatum
  2. Mild: Oval pit near infrasternal notch
  3. Severe: Sinking of entire lower Sternum

VII. Complications

  1. Restrictive Lung Disease in severe cases

VIII. References

  1. Degowin (1987) Bedside Exam, Macmillan, p. 274
  2. Murray and Nadel (2000) Respiratory Medicine, p. 2364-6

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