mini-presentation about the pectus excavatum with association conditions and how to measure the severity and treatment

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Pectus excavatum
Hisham AlKhatib, M.D.
Consultant Radiologist
•‫هللا‬ ‫رسول‬ ‫على‬ ‫والصالة‬ ‫هلل‬ ‫الحمد‬
‫اجمعين‬ ‫م‬ّ‫وسل‬ ‫وصحبه‬ ‫واله‬
•‫بما‬ ‫وعلمني‬ ‫علمتني‬ ‫بما‬ ‫انفعني‬ ‫اللهم‬
‫العليم‬ ‫انك‬ ، ‫علما‬ ‫وزدني‬ ‫ينفعني‬
‫الحكيم‬

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Association
• Marfan syndrome
• Noonan syndrome
• Ehlers Danlos syndrome
• neurofibromatosis type I
• myotonic dystrophy
• fetal alcohol syndrome
• homocystinuria
• osteogenesis imperfecta
• congenital scoliosis
• Poland syndrome
Haller index
• (maximal transverse diameter/narrowest AP
length of chest) is used to assess severity of
incursion of the sternum into the
mediastinum.
• Normal Haller index is 2.5.
• Significant pectus excavatum has an index
greater than 3.25, representing the standard
for determining candidacy for repair

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Nuss procedure
• (also termed MIRPE - minimally invasive repair of
pectus excavatum) is one of the operative
treatments employed in patients with pectus
excavatum.
• It involves inserting of one (or more) concave metal
bars beneath the sternum in the anterior chest wall
• A reverse Nuss procedure can be performed for
treatment of pectus carinatum ; the main difference
is that the bar is placed superficially to the sternum,
instead of deep to the sternum, to pull the sternum
back towards the spine.