Pediatric Pectus Carinatum

Pediatric pectus carinatum, also known as pigeon or keel chest, is a congenital condition where a child’s breastbone (sternum) and ribs protrude outward. It’s commonly noticed during a child’s early teen years when puberty and physical changes make it more visible.

There are two types of pectus carinatum: chondrogladiolar (most common) and chondromanubrial.

This condition is the opposite of pectus excavatum, an abnormal formation of the rib cage that gives the chest a sunken or caved in appearance.

Pectus carinatum isn’t life-threatening, but it can prevent lungs from functioning properly.

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What causes it?

Pectus carinatum is more common in boys than in girls. The exact cause is unknown, but it is believed to be associated with conditions such as Marfan syndrome, Noonan syndrome, Morquio syndrome, scoliosis, asthma, bronchitis, or mitral valve prolapse.

What are the symptoms?

People diagnosed with pectus carinatum may have posture issues or back pain. They may also experience some chest pain which is tied to certain activities and positions. Pectus carinatum can lead to self-image issues or feelings of embarrassment and disrupt normal social development in children.

How is it diagnosed?

Pectus carinatum is usually identified through a physical examination. Doctors may also check for scoliosis. Imaging tests performed can include an X-ray, CT scan, or MRI.

How is it treated?

Depending on the severity of pectus carinatum, doctors may recommend orthotic bracing, which is a nonsurgical procedure that is generally more effective in children. This treatment works best before a child reaches puberty.

In older patients where the chest walls are more rigid and developed, surgery may be recommended to correct deformity and improve heart and lung function. Traditional surgeries are performed using a Ravitch procedure. Speak to your doctor for more information.

After surgery, most children recover well and can return to normal activities within a few weeks. Regular follow-up visits are needed with your surgeon to ensure that the chest is healing correctly and any complications are addressed promptly.

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