Thoracic abnormalities include chest wall deformities and congenital pulmonary airway malformations.
Chest wall deformities include pectus excavatum (sunken chest) and pectus carinatum (protruding chest).
Pectus excavatum is a genetic condition that is often present at birth. In children with pectus excavatum, several ribs and the breastbone (sternum) grow abnormally and turn inward, forming a hollow in the center of the chest. The condition can be mild and barely noticeable or so severe that the heart and lungs are affected.
Pectus carinatum is a disorder that affects the cartilage of the rib bones and the sternum, resulting in an anterior protrusion of the chest. The connective tissue becomes too stretchy, pushing the bones outward. The heart and lungs develop normally. Pectus carinatum is not always present at birth and can develop and worsen as a child gets older, especially during growth spurts. The condition is more common in boys than in girls.
Pectus carinatum may occur alone or along with other conditions, including:
Congenital pulmonary airway malformation (CPAM) is a type of congenital pulmonary anomaly. CPAM involves an abnormal piece of lung tissue that appears as a mass distinct from the normal lung on imaging tests.
Symptoms of thoracic abnormalities can range from asymptomatic to pain and breathing complications. Symptoms of pectus excavatum and pectus carinatum include:
Symptoms of CPAM include:
A multidisciplinary team of pediatric specialists in surgery, obstetrics, maternal fetal health, neonatology and pulmonology monitors developing babies and children with thoracic abnormalities. Ultrasound and fetal magnetic resonance imaging (MRI) scans are used to track development of congenital pulmonary airway malformations and check heart and lung formation.
In most cases, treatment is not needed before birth. Many children with congenital pulmonary airway malformations will need treatment during the first year of life, while other children can lead normal lives without surgery. Children with pectus excavatum or pectus carinatum may need treatment to improve breathing or appearance.
Doctors at Riley at IU Health perform the following exams and tests to diagnose thoracic abnormalities:
The most common treatment for thoracic abnormalities is regular monitoring by a pediatric surgeon to track the size of any existing congenital pulmonary airway malformations or the extent of pectus excavatum or pectus carinatum. Other treatments include:
Visit the links below to learn more about thoracic abnormalities and find support groups.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
Doctors in the Pediatric Surgery Department at Riley at IU Health participate in research related to cancerous thoracic abnormalities through the Children's Oncology Group. Additional research studies focus on how to shorten a child's length of stay in the hospital after surgery and how to achieve the most pain-free procedure for correcting pectus excavatum.
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