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Pectus excavatum - CPR-1000 Current Probe Reader - Chinese SHU-1000 test bench

Signs and symptoms The hallmark of the condition is a sunken appearance sternum. The heart may be displaced and rotated o. mitral valve prolapse may also be present. Base of lung capacity decreases. Researchers are currently causing doubts about the true cause of pectus excavatum, but the hypothesis of genetic defects. Approximately 37% of people with pectus excavatum have a family member with the disease first grade. Physiologically, the increased pressure in the uterus, rickets and increased traction on the sternum because to abnormalities of the membrane have been postulated as specific mechanisms.

The pectus excavatum is also a relatively common symptom syndrome Marfan. Many children with spinal muscular atrophy develop pectus excavatum, due to diaphragmatic breathing, which is common with the disease. Pathophysiology For the heart is located behind the sternum, and because individuals with pectus excavatum has been shown to have visible deformities of the heart (seen in both images radiological and after the autopsy), it has been hypothesized that there is deterioration of the cardiovascular system function in individuals with pectus excavatum. While some studies have shown decreased cardiovascular function in pectus excavatum, there has been no consensus on the physiological basis of new evidence (such as echocardiography) the presence or degree of deterioration in cardiovascular function in people with pectus excavatum. Similarly, there was consensus on the degree of functional improvement after corrective surgery. Diagnostic exploration Cross section of a chest with pectus excavatum pectus excavatum is initially suspected by visual examination of the anterior chest. Chest auscultation may reveal heartbeat displaced and the valve prolapse. You can not have a heart murmur during systole that occur because of the proximity between the sternum and the pulmonary artery. clear lung sounds are usually even decreased due to reduced lung capacity base. Many scales have been developed to determine the degree of chest wall deformity. Most of these are variants of the distance between the sternum and spine cord. One such index is the ratio of gravity Backer degrees of deformity based on the relationship between the diameter of the vertebral body closest to xiphosternal crossing and the distance between the union and the closest xiphosternal vertebral body. More recently, the Haller index was used based on CT.

An index of more than 3.25 are often defined as serious. The Haller index is the ratio of the horizontal distance from the inside of the rib cage and the shortest distance between the vertebrae and sternum. Chest X-rays are also useful in diagnosis. Chest radiography in pectus excavatum may show an opacity in the right lung area that can be confused with an infiltrate (as seen with pneumonia). Some studies also suggest that the rate Haller can be calculated on the basis of chest radiography versus CT in individuals who have no limitation in function. The pectus excavatum is to differentiate the other disorders by removing a series of signs and symptoms. Pectus carinatum is excluded by the simple observation of a collapse of the sternum instead a protrusion. Kyphoscoliosis is excluded by imaging the spine, where the column pectus excavatum is usually normal in structure. Treatment for pectus excavatum may involve invasive or noninvasive techniques, or a combination of both. Before an operation the product of several tests are usually performed. These including but not limited to, a CT scan, pulmonary function tests and cardiac examinations (as auscultation and ECG). After a CT takes the Haller index measured. The patient Haller is calculated by obtaining the ratio of transverse diameter (the horizontal distance inside the rib cage) and antero-posterior diameter (the shortest distance between the vertebrae and sternum).

A Haller index greater that 3.25 is generally considered serious, while the normal breast has an index of 2.5. Cardiopulmonary tests are used to determine lung capacity and check in heart murmurs. Surgery Surgical correction has been shown to repair any functional symptoms that can occur in the disease, such as problems respiratory or heart murmurs, provided that no permanent damage has emerged from an extremely serious case. Ravitch technique Ravitch technique is invasive surgery was introduced in 1949 and developed in the 1950s to treat the condition. This procedure involves creating an incision through the chest through which the cartilage is removed and separated from the sternum. A small bar is inserted under the sternum to hold it in position.

The bar is left in place until the cartilage to grow back, usually around six months. The bar is then removed in a simple office procedure. Ravitch technique is not practical widespread because it is very invasive. It is often used in older patients, where the sternum has calcified, when the deformity is asymmetrical, or when the procedure Less invasive Nuss has been successful. [Citation needed] The Nuss procedure Main article: lung exercises Nuss procedure, used after surgery corrective to prevent pneumonia and broaden the base of the X-ray lung capacity of a man of 15 years, after undergoing the Nuss procedure since the Dr. Donald Nuss, based at Children's Hospital of The King's Daughters (CHKD) in Norfolk, Virginia, has developed a technique that is minimally invasive. The Nuss procedure involves sliding one or more concave steel bars into the chest under the sternum. The bar is cast to a convex position to push outward on the sternum, correction of the deformity. The bar usually stays in the body for about two years, although many surgeons are now about to leave to a maximum of five years. When the bones have solidified in place, the bar is removed through outpatient surgery. vacuum chamber and the main compressor Rib article: the Vacuum bell (medicine) A relatively new alternative to surgery is a vacuum chamber. It consists of a bowl-shaped device that fits the collapsed area the air is removed using a hand pump.

The vacuum created by this elevates the sternum up, decreasing the severity of the deformity. As device is so new there is currently no information on whether it is effective in the long term. The use of the compressor of the rib along with the use of a suction device 7 "has proven effective in the correction of pectus excavatum permanently. The ribs are compressed, while the sternum is lifted by a small suction device 7 "this sets the ribs in the desired position and thus solves the postition of the sternum. Cosmetic light treatments and cosmetic appearance of pectus excavatum can be treated with a dermal filler called Bio-Alcamid. However, as this does nothing to alleviate the actual deformation will not prevent physiological symptoms caused by disease. Mild cases have also reportedly been treated with life support, such as orthopedic braces and exercise. There are also available for prosthetic implants fill the depressed area. Solid silicone implants have been used successfully for many years with acceptable results in some cases. More recently, an implant Porex has been used, a similar material used to replace brain surgery on the skull and severe head injuries. magnetic mini-mover procedure procedure magnetic mini-motor (3MP) is a technique used to correct the pectus excavatum by using two magnets to realign the sternum with the rest of the chest and ribs. A magnet is inserted 1 cm into the patient's body at the lower end of the sternum, the other is placed externally on a custom fitted stand. These two magnets generate about 0.04 tesla (T) in order to move slowly toward the outside of the sternum for several years. The maximum magnetic field that can be applied safely to the body is about 4 T, making this technique safe from the magnetic point of view. main advantages of the technique are that 3MP is more profitable than the main surgical approaches as the Nuss procedure, and is considerably less painful operation.

One of the potential adverse effects of 3MP is the inactivation of implanted devices, as an artificial pacemaker. From 3MP is still in a probationary period is not known whether long-term to bring the magnet affect the skin or other organs. Epidemiology The pectus excavatum occurs in approximately 1 in every 150-1000 births, with male predominance (male / female ratio of 3:1). The cases of the disease in family members been reported in 35% to 45% of cases. In pectus excavatum animals is also known to occur in animals, for example, the Munchkin cat breed. Some procedures used to treat disease in animals have not been used in humans, such as the use of a cast with sutures wrapped around the sternum and internal splints and external. These techniques are generally used in immature animals of flexible cartilage. See also References keel chest ^ chief lexicographer Douglas M. Anderson (2003) Pectus Excavatum (28 ed.) Medicla Dorland Dictionary: Saunders, ISBN 0721601464, http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/ Abcd ^ dorlands/dorland/nine/000955637.htm Shamberger RC (1996). "Congenital deformities of the chest wall." Curr Probl Surg 33 (6): 469 542. doi: 10.1016/S0011-3840 (96) 80005-0. PMID 8641129. Abcd ^ Crump HW (1992). "Pectus excavatum". I'm a doctor Fam 46 (1): 1739. PMID 1621629. http://web.archive.org/web/20071007004245/http://findarticles.com/p/articles/mi_m3225/is_n1_v46/ai_12450746. ^ "Pectus excavatum. MedLine Plus Medical Encyclopedia. U.S. National Library of Medicine and the National Institutes of Health. 11/12/2007. http://www.nlm.nih.gov/medlineplus/ency/article/003320.htm # Considerations. ^ "Pectus excavatum. http://www.fpnotebook.com/Lung/Exam/PctsExcvtm.htm. ^ Spence, Roy AJ, Patrick J. Morrison (2005). Genetics of Surgeons. Remeasurement Publishing. ISBN 1-901346-69-2. http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=Pectus excavatum and dispose = gfs.section.344. ^ Abc "Pectus Excavatum eMedicine. André Hebra. http://emedicine.medscape.com/article/1004953-overview. ^ "EMedicine Marfan Syndrome." Harold Chen. http://emedicine.medscape.com/article/946315-overview. Guller B ^, K Hable (1974). "Cardiac findings in pectus excavatum in children: review and differential diagnosis." Chest 66 (2): 16 571. doi: 10.1378/chest.66.2.165. PMID 4850886. http://www.chestjournal.org/cgi/reprint/66/2/165. BALANCE ^ OG, Brunner S, V LARSEN (1961). "Surgical treatment funnel chest. Initial and follow-up results. "Acta Chir Scand 121: 25 361. PMID 13685690. ^ Jeannette Diana-Zerpa, Thacz Nancy Browne, Laura M. Flanigan, Caramel McComiskey A.; Pam Pieper (2006). Pediatric Nursing Care of the Surgical Patient (Browne, Nursing Care of the pediatric surgical patient). Sudbury Massachusetts: Jones & Bartlett Publishers. p. 253. ISBN 0-7637-4052-7. Ab ^ Haller JA, Kramer SS, Lietman SA (1987). "The use of CT in selecting patients for surgery for pectus excavatum: a preliminary report. "J. Pediatr. Surg. 22 (10): 9046. doi: 10.1016/S0022-3468 (87) 80585-7. PMID 3681619. http://linkinghub.elsevier. com/retrieve/pii/S0022346887000277. ^ Hoeffel JC, Winants D, Marcon F, Worms AM (1990). "Radioopacity paracardiac right lung due to pectus excavatum (funnel chest)." Rontgenblatter 43 (7): 298 300. PMID 2392647. Mueller ^ C, Saint-Vil D, Bouchard S (2008). "Chest x-ray as a primary field of preoperative imaging modality of pectus excavatum. "J. Pediatr. Surg. 43 (1): 713. doi: 10.1016/j.jpedsurg.2007.09.023. PMID 18206458. ^" How to measure the Haller. Department of Cardiology and Respiratory Medicine, Hospital das clinically da Faculdade de Medicina, University of So Paulo Thoracic Surgery Sector "(PDF). http://www.scielo.br/pdf/jbpneu/v30n6/en_a03v30n6.pdf. ^ "The Nuss procedure for pectus excavatum correction." Swoveland Barbara, Clara Medrick, Marilyn Kirsh, Kevin G. Thompson, Donald Nussm. http://findarticles.com/p/articles/mi_m0FSL/is_6_74/ai_81218971. ^ "Pectus Excavatum view" (PDF). CIGNA. http://www.cigna.com/customer_care/healthcare_professional/coverage_positions/medical/mm_0309_coveragepositioncriteria_surgical_treatment_chest_wall_deformities.pdf. Ravitch MM ^ (April 1949). "Surgical treatment of pectus excavatum. Ann Surg 129 (4): 42 944. doi: 10.1097/00000658-194904000-00002. PMID 17859324. ^ Nuss D, Kelly Jr RE, Croitoru DP, Katz ME (April 1998). "A review of 10 years in a minimally invasive technique for correction of pectus excavatum. J Pediatr Surg 33 (4): 54 552. doi: 10.1016/S0022-3468 (98) 90314-1. PMID 9574749. ^ Pilegaard, HK, Licht PB (February 2008). "The first results after the operation Nuss for pectus excavatum - a single institution experience of 383 patients. "Interactive Cardiovascular and Thoracic Surgery (Oxford University Press) 7 (1): 5457. doi: 10.1510/icvts.2007.160937. PMID 17951271. http://icvts.ctsnetjournals.org/cgi/content/full/7/1/54. Retrieved on 18/04/2008. ^ Haecker, FM, J Mayr (April 2006). "The vacuum chamber for the treatment of pectus excavatum: an alternative to surgical correction?". European Journal of Cardiothoracic Surgery 29 (April): 557 561. doi: 10.1016/j.ejcts.2006.01.025. PMID 16473516. ^ Lahiri, A, R Waters (February 2007). "The experience with Bio-Alcamid, a new stent tissue soft. "Journal of Plastic, Reconstructive and Aesthetic Surgery 60 (6): 663 667. doi: 10.1016/j.bjps.2006.07.010. PMID 17485056. ^" Orthopectus. " Dr. Sydney A. Haje, Orthopedist. http://www.orthopectus.com.br/fmethod.htm. Saoura ^ S, H Shaaban, J McPhail, P McArthur (September 2007). "Silicone Implants as for the reconstruction of chest wall defects: technique of manufacture and the final results. "Aesthetica J Plast Reconstr Surg 61: 1205. doi: 10.1016/j.bjps.2007.07.019. PMID 18178533. http://linkinghub.elsevier.com/retrieve/pii/S1748 -6815 (07) 00405-6. Retrieved on 2008-08-21. ^ G Wechselberger, M Ohlbauer, Haslinger J, Schoeller T, Bauer T, Piza-Katzer H (November 2001). "Silicone implant correction of pectus excavatum. Ann Plast Surg 47 (5): 48 993. doi: 10.1097/00000637-200111000-00003. PMID 11716258. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0148-7043&volume=47&issue=5&spage=489. Retrieved Grappolini on 08/21/2008. ^ S, PM Fanzio, PG D'Addetta, Todd A, Infante M (January 2008). "Aesthetic treatment of pectus excavatum: a new technique endoscopy using a porous polyethylene implant. "Aesthetic Plast Surg 32 (1): 10,510. doi: 10.1007/s00266-007-9025-6. PMID 17851713. ^ ab Harrison, RM; Estefan-D Ventura, Fechter R et al. (January 2007). "Magnetic Mini-Mover Procedure for pectus excavatum: I. Development, design and simulations for feasibility and safety" (PDF). Journal of Pediatric Surgery 42 (1): 8185. doi: 10.1016/j.jpedsurg.2006.09.042. PMID 17208545. http://pedsurg.ucsf.edu/media/92580/pectus_article.pdf. Retrieved on 04/23/2008. ^ "Pectus Excavatum: Frequently Asked Questions: Surgery: UI Issues Health." Harold M. McGillin Burkhart and Joan Ricks. http://www.uihealthcare.com/topics/medicaldepartments/surgery/pectusexcavatum/index.html. ^ "Genetic abnormalities in cats." http://www.messybeast.com/gene-anomalies.htm. ^ Fossum, TW, RJ Boudrieau, HP Hobson, Rudy RL (1989). "Correction surgical pectus excavatum, using external splint in two dogs and a cat. "J. Am. Vet. Med Assoc. 195 (1): 917. PMID 2759902. ^ M Risselada, H Gallo, T Liuti, Polis R, H van Bree (2006). "Use of internal splinting to realign the noncompliant sternum in a cat with pectus excavatum. J. Am Vet. Med Assoc. 228 (7): 104 752. doi: 10.2460/javma.228.7.1047. PMID 16579783. http://avmajournals.avma.org/doi/abs/10.2460/javma.228.7.1047. ^ McAnulty JF, Harvey CE (1989). "Repair of pectus excavatum by percutaneous suturing and temporary external coaptation in a "kitty. J. Am. Vet. Med Assoc. 194 (8): 10 657. PMID 2651373. External links Wikimedia Commons has media related to pectus excavatum Pectus Look up in Wiktionary, the free dictionary. Pectus excavatum in the Open Directory Project V of congenital malformations and deformations of musculoskeletal system / musculoskeletal abnormality (-Q76 P65, 754 to 756.3) tips / dysmelia superior clavicle / shoulder dysostosis Sprengel deformity cleidocranial Wallis Zieff Goldblatt syndrome hand deformity: Madelung's deformity Clinodactyly oligodactyly Polydactyly Baja hip: Dislocation of hop / hip dysplasia disease Upington coxa valga coxa vara knee: Genu varum Genu valgus deformity of the foot: feet foot flat Club Rocker cavus foot bottom dactyly Either both / Digit: Polydactyly / syndactyly (webbed fingers) Arachnodactyly Cenani Lenz syndactylism Ectrodactyly Brachydactyly deficit reduction / Share: ectromelia Acheiropodia (phocomelia, Amelia, hemimelia) multiple joints: Arthrogryposis Rapadilino Larsen syndrome craniosynostosis craniofacial syndrome: scaphocephaly Oxycephaly Trigonocephaly Craniofacial dysostosis: Crouzon syndrome Hallermann-Streiff hypertelorism syndrome Treacher Collins syndrome other: Macrocephaly Platybasia dysplasia Greig dolichocephaly cephalopolysyndactyly Craniodiaphyseal saddle nose syndrome Plagiocephaly Other axial spine: spinal curvature (scoliosis) the Klippel-Feil Spina bifida occulta Spondylolisthesis ribs: Cervical rib bifid rib sternum: Pectus excavatum Pectus carinatum joint routes: anat arthropathies, non-congenital / Deformities / dorsopathies / arthropathy / soft tissue defects, signs of the same name, proc Categories: Diseases of the musculoskeletal system | Diseases congenital | Human appearance | Congenital disorders of the locomotor systemHidden categories: All articles with unsourced statements | Articles needing references statements in June 2008

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