Pectus carinatum

Last revised by Daniel J Bell on 13 Sep 2023

Pectus carinatum, otherwise known as a pigeon chest, refers to a chest wall deformity in which the sternum protrudes anteriorly. It is less common than pectus excavatum.

Patients may present with dyspnea and exercise intolerance.

A pectus carinatum may be demonstrated on lateral chest radiographs or cross-sectional imaging of the chest. There are two patterns of sternal protrusion:

  • chondrogladiolar: protrusion of the middle and lower sternum

  • chondromanubrial: protrusion of the manubrium and upper sternum (less common); known as Currarino-Silverman syndrome

Treatment options include non-surgical external bracing, typically for adolescents 5. The average Haller index in patients requiring corrective pectus carinatum surgery is 1.8 7

Surgical repair usually results in symptomatic improvement 3 with a variety of techniques include open Ravitch procedure, open or thoracoscopic minimal cartilage resection or the reverse Nuss procedure with success rates of ~90% (range 67-100%) 5.

In Latin, pectus means chest and carina is the keel of a ship 6.

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