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Pectus excavatum

Signs and symptoms
Seal OnTheSnow is an appearance sunken sternum. Heart can be displaced or rotation. Mitral prolapse valve can also be present. capacity Base lung is reduced.
Causes
Researchers are currently insurance on real cause chest dug, but postulated the genetic defect. Approximately 37% individuals with excavatum pectus have a member degree first family with condition. Physiologically increased Pressure in utero stunting tension and increasing the breastbone due to Abnormalities of the diaphragm Have Been postulated as specific mechanisms. pectus excavatum also symptoms comparatively common of Marfan syndrome. Children Most Spinal Muscular Atrophy develop excavatum pectus due to diaphragmatic breathing are common with the condition.
Physiopathology
Because your heart is localized behind the breastbone, and because individuals with Pectus excavatum Have Been Shown to Have visible deformities of the heart (seen Both on Radiological imaging and after autopsies) it've Been hypothesized That There is impairment of function the cardiovascular individuals pectus excavatum. While Some studies Have Demonstrated Decreased cardiovascular Function in Pectus excavatum, There has-been not consensus Reached Based On newer Physiological test (Such Ace echocardiography) of the Presence or degree of impairment in cardiovascular function in people with pectus excavatum. Similarly hay hay consensus degree functional improvement after corrective surgery.
Diagnosis
Cruz sectional exploration Breast pectus excavatum
Pectus excavatum initially suspicious from visual examination Anterior chest. Auscultation chest can reveal displaced heartbeat and prolapse valve. There Can Be to heart murmur Occurring DURING systole Caused by proximity between sternum pulmonary artery. lung sounds are generally clear yet diminished due capacity decreased lung base.
scales Many have developed determine the deformity the ribcage. The majority these variants the distancia breastbone and spinal. A index bliss is the coefficient Backer what degree severity deformities based ratio diameter vertebral body nearest junction xiphosternal and distance between junction xiphosternal and closer body vertebral. Most recently Index Haller have been used on the basis of CT measurements. Indexed to 3.25 usually defined as severe. Del índice Haller is the ratio horizontal distance interior chest the minor remotely vertebrae and breastbone.
Chest x-rays Are También Useful in the diagnosis. Radiographs ray excavatum pectus can show one opacities lung area right that can confound infiltrate (As observed pneumonia). Some studies also suggest index Haller can calculated based chest radiograph unlike TC in individuals have any impaired function.
Pectus excavatum is Differentiated from Other Disorders, by the series of Elimination of Signs and Symptoms. carinatum pectus is excluded by simple observation a collapsing breastbone instead protrusion a. Kyphoscoliosis Is Excluded by diagnostic Imaging of the spine, where, in pectus excavatum the spine Usually Appears normal in structure.
Treatment
Treatment pectus excavatum you can involve either invasive or non-invasive or combining both. Before an operation Proceeds Several tests Are Usually To Be Performed. These include but not limited to tomography exploration, essays pulmonary Function and examinations cardiology (Such as auscultation and ECG). Then a TAC is taken index Haller measured. Haller patient is calculated when obtaining diameter ratio transversal (distance horizontal interior ribcage) and diameter anteroposterior (minor distance between vertebrae and sternum). A Haller Index superiors 3.25 generally consider serious but normal breasts have index 2.5. The cardiopulmonary tests Are Used To determine the lung Capacity and to check for heart murmurs.
Surgery
Surgical correction hast Been Shown to repair and Stock functional Symptoms That May OCCUR in the condition, Such As respiratory Problems or heart murmurs, Provides that permanent damage has yet emerged a case extremely serious.
Ravitch technical
El technique Ravitch is surgery invasive had introduced in 1949 developed in 1950 treating situation. This procedure Involves Creating an incision Along the chest Through Which the cartilage is removed and the sternum detached. A small bar then inserted under Technique Ravitch not very practiced because is so invasive. It is Often Used in old older Patients, WHERE the sternum've calcifi, When the deformity is Asymmetrical, Or When the less invasive procedure Nuss demonstrated ineffective. [Citation needed]
Nuss processing
Main article: Procedure Nuss
Lung Exercisers, use after remedial surgery to avoid base pneumonia and increase lung capacity
X "Ray of a male Year 15 old after undergoing the procedure Nuss
, Since then Dr. Donald Nuss, base del Children's Hospitalario de Las hijas de Rey (CHKD) en Norfolk Illinois ha desarrollado una técnica que es mínimamente invasivo. The procedure Nuss implies sliding one or more bars steel concave chest beneath sternum. La barra se voltea a una posición convexa para empujar externas sobre el esternón, corrigiendo la deformidad. Los bares suelen permanezca en cuerpo de aproximadamente dos años, aunque caved-in area; the air is then removed by the use of a hand pump. Las vacuum created by rising rising sternum decreasing severity deformity. As said device past currently no information if effective long term. Use Compressor rib along with use a device suction 7 "has proven effective in permanently correct pectus excavatum. Las ribs compress while sternum is rose by a mini 7 device vacuum, "This sets the ribs into the position desired and so correcting Postition breastbone.
Cosmetic and treatment Light
Appearance pectus excavatum can treated with a dermal filler Bio-Alcamid. However, since this does nothing to alleviate the real also implants prosthetics available to fill the area depressed. Solid silicone implants Have Been successfully Used For Many Years with acceptable results In Some cases. More recently an implant Porex've Been Used Which Is to similar material Used To replace skull in brain surgery and Severed Head revile.
proceedings Magnetic Mini motor
The procedure magnetic mini promoter (3MP) is to technique Used To correct excavatum by using Two magnets to Realign the sternum with the rest of the chest and ribcage. An switch is added to 1 cm to the national patients on the lower end-of-the sternum, The Other Is Placed externally Onto to custom Fitted Brace. These two magnets generate around 0.04 tesla (T) in order to slowly move the sternum outwards over several years. The maximum field magnetic can applied body safe is around 4 T, making this safe technique perspective magnetic. main advantages technique 3MP de son que es más rentable que principales abordajes quirúrgicos como el procedimiento Nuss y es considerablemente menos doloroso postoperatoriamente. Effect potential adverse 3MP is inactivation implanted devices as pacemakers artificial. Since the 3MP is still in a trial period it is unknown whether long term wearing of the magnet will Affect the skin or Other vital organs.
Epidemiology
Pectus excavatum Occurs in an Estimated 1 in 150-1000 births, with male Predominance (male-to-female ratio of 3:1). Occurrences such requirement family have been reported at 35% to 45% of cases.
In animals
Pectus excavatum known also occur animal example race Munchkin Cat. Some procedures used treat the condition in animals Have Not Been Used in Humans, Such As the use of a cast with sutures wrapped around the sternum and the use of internal and external splints. These techniques usually used in immature animals cartilage flexibility.
See also
Pectus carinatum
References
^ Chief lexicographer Douglas M. Anderson (2003), Pectus excavatum (twenty Ed.), MEDICLEAN Dorland Dictionary: Saunders ISBN 0721601464, http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/ dorlands / Dorland / nine/000955637.htm
^ ABCD Shamberger rc (1996). «Deformities Congenital chest wall." Curr probl Surg 33 (six) 469.542. Doi: 10.1016/S0011-3840 (96) 80005-0. PMID 8,641,129.
Bcd HW ^ A Crump (1992). 'Pectus excavatum. I'ma doctor Fam 46 (un) 1739. PMID 1,621,629. http://web.archive.org/web/20071007004245/http://findarticles.com/p/articles/mi_m3225/is_n1_v46/ai_12450746.
^ "Pectus excavatum. MedLine More encyclopedia physician. U.S. Library of Medicine and the National Institute of Health. 12.11.2007. http://www.nlm.nih.gov/medlineplus/ency/article/003320.htm # Considerations.
^ "Thorax funnel." http://www.fpnotebook.com/Lung/Exam/PctsExcvtm.htm.
Spence ^, Roy AJ; Patrick J. Morrison (2005). Genetics to surgeons. Remedica Publishing. ISBN 1-901346-69-2. excavatum http://www.ncbi.nlm.nih.gov/books/bv.fcgi?highlight=Pectus and dispose = gfs.section.344.
^ Abc "eMedicine Pectus excavatum." Andres Hebra. Http: / / emedicine.medscape.com/article/1004953-overview.
^ "Emedicine Marfan Syndrome." Chen Harold. http://emedicine.medscape.com/article/946315-overview.
^ B Guller, K talk (, 1974.) 'Conclusions cardiac pectus excavatum children: consideration and differential diagnosis. " Pecho 66 (2): 16571. doi: 10.1378/chest.66.2.165. PMID 4850886. http://www.chestjournal.org/cgi/reprint/66/2/165.
^ GO Backer S BRUNNER, V LARSEN (1961). Surgical treatment funnel thoracic. Initials and Performance above. "Chir Acta Scand 121 25,361. PMID 13,685,690.
^ Jeannette Diana Zerpa, Nancy Thacz Browne, Laura M. Flanigan; caramel McComiskey A.; Pieper pam (2006). Nursing Care Of The Paediatric Surgical Patient (Browne, Nursing Care Of The Pediatric Surgical Patient). Sudbury, Mass: Jones & Editors Bartlett. p. 253. ISBN 0-7637-4052-7.
ab ^ Haller EJ, stainless steel Kramer HS Lietman (, 1 987.) "Application of CT analysis in selection of patients to surgical pectus excavatum: report preview" J. Pediatr Surg twenty-two (10) ... 9046 doi. 10.1016/S0022-3468 (87) 80585-7 PMID 3681619 http://linkinghub .. .elsevier.com/retrieve/pii/S0022346887000277.
^ AD Hoeffel, Winants D Marcon F maggots AM (1990). "Radiopacity of field right lung paracardiac by pectus excavatum (funnel thorax). Rontgenblatter 43 (7) 298.300. PMID 2392647.
^ C Mueller, Saint-Vil D, S Bouchard (2008). "Chest ray X as modality elementary preoperative images pectus excavatum ". J. Pediatr. Surg. 43 (1): 713. doi: 10.1016/j.jpedsurg.2007.09.023. PMID 18206458.
^ "Cómo el Haller se mide. Departamento de Cardiología y Neumología del Hospital das Clnicas da Faculdade de Medicina bis la Universidad de So Paulo Torácica Cirugía sector "(Pdf). http://www.scielo.br/pdf/jbpneu/v30n6/en_a03v30n6.pdf.
^ "El Nuss procedure correction excavatum pectus." Barbara Swoveland, Medrick Clare Kirsh Marilyn, Kevin G Thompson, Nussm Donald. http://findarticles.com/p/articles/mi_m0FSL/is_6_74/ai_81218971.
^ "Pectus Excavatum overview "(PDF). CIGNA. http://www.cigna.com/customer_care/healthcare_professional/coverage_positions/medical/mm_0309_coveragepositioncriteria_surgical_treatment_chest_wall_deformities.pdf.
^ Ravitch MM (Apr. 1949). "Treatment operative excavatum Pectus". Ann Surg 129 (4): 42944. doi: 10.1097/00000658-194904000-00002. PMID 17859324.
Nuss ^ D, Jr Kelly RE, AD Croitoru, Katz EM (04 1998). "A 10-year review of a minimally invasive technique for the correction of pectus excavatum." J Pediatr Surg 33 (four) 54,552. doi: 10.1016/S0022-3468 (98) 90314-1. PMID 9,574,749.
Pilegaard ^, HK; PB Licht (February 2008). "Early following results operation Nuss for excavatum pectus - experience single institution 383 patients ". Interactivos Cardiovascular and thoracic surgery (University Press) 7 (un) 5457. doi: 10.1510/icvts.2007.160937. PMID 17951271. http://icvts.ctsnetjournals.org/cgi/content/full/7/1/54. Retrieved 18/04/2008.
Haecker ^ FM Mayr J (Apr. 2006). "The bell empty for treatment excavatum pectus:? Alternative to surgical repair. European Journal of Surgery Cardiothoracic 29 (4), 557561. DOI: 10.1016/j.ejcts.2006.01.025. PMID 16473516.
Lahiri ^, A; R Aguas (February 2007). "Experience with Bio-Alcamid, an endoprosthesis new soft tissues Journal of Plástica Reconstructive and surgery aesthetics sixty (six). 663,667 DOI:. 10.1016/j.bjps.2006.07.010 PMID 17485056 ..
^ "Orthopectus." Dr. Sydney A. Haje orthopedic. http://www.orthopectus.com.br/fmethod.htm.
S ^ Saoura, M Shaaban, McPhail J P McArthur (September 2007). "Custom prosthesis silicone for defect reconstruction chest wall: technique outcome manufacture and final ". Plast J Reconstr Aesthete 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 21/08/2008.
G ^ Wechselberger, M Ohlbauer, Haslinger J, Schoeller T, T Bauer, H Piza-Katzer (November 2001). "Silicone implant correction of excavatum Pectus ". 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 on 21/08/2008.
^ S Grappolini, PM Fanzio, D'PG Addetta Todd A M, Infante (January 2008). Aesthetic management of pectus excavatum: new endoscopic technique using implantation porous polyethylene Aesthetics Plast Surg 32 (1),. 10510 doi: .. 10.1007/s00266-007-9025-6 PMID 17,851,713.
^ Harrison ab IM; Estefan Ventura D Fechter R et. (January 2007). "Magnetic mini-Mover Procedure excavatum pectus: 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 17,208,545. http://pedsurg.ucsf.edu/media/92580/pectus_article.pdf. Retrieved 4.23.2008.
^ Harold M. Burkhart and Joan Ricks-McGillin. http://www.uihealthcare.com/topics/medicaldepartments/surgery/pectusexcavatum/index.html.
^ «Abnormalities genetic cats. http://www.messybeast.com/gene-anomalies.htm.
Fossum ^ TW; Boudrieau Hobson RJ HP, Rudy de RL (1989). "Surgical correction of of pectus excavatum using external splint two dogs already cat "J. am Vet Med Assoc 195 (1 ):...... 917 PMID 2759902.
H ^ Risselada, De H Rooster T Liuti, Polis Yo H Van Bree (2006). «Using splinting internal to readjust a breastbone obedient in a cat excavatum pectus. 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.
^ JF McAnulty, Harvey CE (1989). «Repair pectus excavatum Percutaneous suture coaptation temporary external a "kitten J. Am Vet Med Assoc 194 (8 ):...... 10657 PMID 2651373.
External Links
Wikimedia Commons has multimedia regarding: Pectus excavatum
Mira pectus Wiktionary, the free dictionary.
Pectus excavatum Project Open Directory
EV
Congenital Cleidocranial dysostosis deformity Sprengel Wallis Zieff syndrome Goldblatt
deformity hand deformity Madelung Clinodactyly oligodactyly Polydactyly
Baja
hip: Luxation hip / of DC Upington diseases Coxa coxa valga rod
knee genu Genu Genu varum
feet deformity Club Apartment meters foot Pes cavo foot Rocking
O / two
dactyly / digits: Polydactyly / syndactyly (Fingers Webbed) Arachnodactyly Cenani Lenz syndactylism Ectrodactyly Brachydactyly
deficits reduction and part: ectromelia Acheiropodia (phocomelia, Amelia, hemimelia)
together various: Arthrogryposis the syndrome Larsen Rapadilino syndrome
Craniofacial
Craniosynostosis: Scaphocephaly Oxycephaly trigonocephaly
Craniofacial dysostosis: syndrome Crouzon Hypertelorism Hallermann-Streiff Treacher Syndrome Collins syndrome
Another: macrocephaly Platybasia dysplasia Craniodiaphyseal dolichocephaly Greig cephalopolysyndactyly syndrome plagiocephaly Saddle nose
Other axial
column: curvature dorsal (Scoliosis) Klippel Feil Spondylolisthesis Espina Espina occulta
ribs: rib cervical bifid rib
breastbone: Pectus excavatum carinatum pectus
NAV joint: arthropathies Anat no congenital / strain / dorsopathies / loose fabric Arthropathy is a congenital eponymous proc
Categories: Musculoskeletal Disorders | inherited disorder | appearance | Human disturbances congenital musculoskeletal categories systemHidden: All articles with statements with no source | Articles with statements no source since June 2008

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