Chicken chest (pectus carinatum) is also known as pigeon chest. Sternum forward bulging deformity, like chicken, pigeon breast so called chicken chest, is the second common chest wall anterior chest deformity, less common than the funnel chest, the incidence rate of about one in a thousand, the male to female ratio of about 4:1, accounting for all chest wall deformity of 16.7%, the symptoms appeared later, more than 50% in 11 years old after the discovery. The etiology has not been clearly defined and may be genetically related, with about 20% to 25% having a family history. It is generally thought to be caused by overgrowth of the ribs and costal cartilage, and the deformity of the sternum is secondary to rib deformities and may be secondary to intrathoracic disease.

Alias

Pigeon chest

English name

Pectus carinatum

Department of Medicine

Cardiothoracic Surgery

Common Causes

Abnormal congenital development, malnutrition, and compression of the chest wall by the enlarged heart

Common Symptoms

Asthma, upper respiratory problems, and respiratory problems. p>Asthma, upper respiratory tract infections and bronchial wheezing

Causes Listen to the voice

1. Congenital developmental anomalies

Congenital chicken chest is genetically related like funnel chest deformity, and there is a significant increase in the incidence of chicken chest in those who have chest wall deformities in their family. During fetal or infantile life, the developmental imbalance between the sternum and the vertebrae and ribs causes the deformity of the thorax. Underdevelopment of the central tendon of the diaphragm attaching to the sternum is a secondary cause; if the anterior portion of the diaphragm is underdeveloped and attaches not to the raphe and the rib arch but to the dorsal side of the rectus abdominis sheath, the lower part of the sternum is moved forward due to the lack of diaphragm support, leading to the formation of a chicken chest deformity.

2. Acquired factors

(1) malnutrition After birth, infants and young children do not get enough nutrition, suffering from certain malnutritional diseases, such as pediatric rickets, which can affect the development of the sternum and so on, resulting in thoracic deformity.

(2) secondary to diseases in the chest cavity, such as some congenital heart disease, the enlarged heart oppression of the chest wall, the formation of chicken chest deformity. Flat chest deformity caused by chronic pyothorax. Long-term chronic respiratory infections can make the respiratory function weakened, in order to meet the respiratory needs, diaphragmatic movement to strengthen, pulling Hao's groove subsidence, and gradually formed chicken chest deformity. There are also secondary to heart or chest surgery.

Clinical manifestations Listening to the voice

1. Symptoms

Most chicken chests are not found after birth like funnel chests, and are often gradually noticed after the age of five or six. In mild cases, the deformity has no effect on cardiopulmonary function, and there are no clinical symptoms. In severe cases, the lengthening of the anterior and posterior diameter of the thorax leads to a weakening of the respiratory amplitude and a decrease in the elasticity of the lung tissues, resulting in shortness of breath and fatigue, and the child often develops recurrent upper respiratory tract infections and asthma, has poor endurance for activities, and is prone to fatigue. Most of the patients are mentally burdened by chest wall deformity, often have low self-esteem, lack of self-confidence, walking, sitting and standing to cover the raised chest, resulting in hunchback, unwilling to swim and participate in outdoor activities. Abnormal posture and lack of exercise will aggravate the deformity.

2. Signs

Mainly the anterior chest wall of the anterior convex deformity, according to the cartilage and sternum forward protruding deformity shape is divided into four types:

(1) symmetrical type for the most common type. The rib cartilage of the lower part of the sternal body is symmetrically projected forward, and the lateral part of the rib cartilage and ribs are concave inward.

(2) Asymmetric type is less common and is characterized by forward protrusion of the rib cartilage on one side and normal or nearly normal rib cartilage on the opposite side.

(3) Mixed chicken chest and funnel chest deformity Rarely, the rib cartilage on one side protrudes anteriorly, and the opposite side is depressed or has a funnel chest deformity, and there is often rotation of the sternum.

(4) upper rib cartilage sternal deformity Very rare, the second to third rib cartilage and the sternal stem protrudes forward, the sternal body is relatively inwardly concave, and the side of the sternum is bowed. This deformity is often accompanied by congenital heart disease, pestle-like fingers (toes) or body too small deformity.