He pectus excavatumalso known as lump hundido, the excavated thorax, it is a congenital malformation in which the hueso of the sternum presents a depression in the center of the pecho, in the region located between the ribs, which causes an alteration of the corporal image that, although in the genere risks for life, can make it difficult self-esteem development or causing psychological changes in children.
The excavated chest can cause severe complications, such as compression of the organs of the region, which leads to the development of infections in the respiratory tract, and makes breathing difficult, which hinders the practice of physical exercise and causes pain.
The only way to completely correct the pectus excavatum there is a surgery to reposition the bones in the correct area, which is why this procedure is indicated, mainly, in cases where symptoms arise.
Symptoms and signs
El pecho excavado is characterized by a depression in the pecho, which can vary from agreement to grave. This malformation can be observed in conditions such as Marfan syndrome, Noonan syndrome, Poland syndrome and osteogenesis imperfecta, for example.
Even the problem can be identified after the birth, in many cases it worsens as the child develops, which is why the treatment is usually indicated in adolescence.
It is important to consult the orthopedist or the general practitioner so that an imaging test can be carried out to confirm the diagnosis, and in this way, it is possible to start the appropriate treatment.
Which are the main causes
The cause of the emergence of the pectus excavatum you are not known; however, it is more common in children and people who have a family history of malformation.
If you are not at risk for a child’s life, hundido pecho can manifest itself early in adolescence and cause symptoms such as palpitations, coughs, feeling of pressure in the chest and respiratory infections.
How is the surgery performed?
The surgery to correct the pectus excavatum It can be carried out in two different ways, depending on the severity and age of the patient. However, in both cases it is performed under general anesthesia and it is necessary to remain hospitalized for around 1 week.
The two forms of surgery are:
- Open surgery or Ravitch surgery: It is used in adults, in moderate to severe cases where the chest is rigid and very asymmetrical, and lasts from 4 to 6 hours. In this technique, a horizontal cut is performed in the breast to remove the abnormal cartilage that joins the ribs to the sternum, allowing the hue to return to its correct position. After that, surgical materials were placed to keep the baby in the correct position;
- Minimally invasive or Nuss surgery: It is usually performed in children and in mild to moderate cases, and lasts from 1 to 2 hours. In this technique, small cuts are performed under the armpit and then a metal bar is inserted between the cut and the other to bring the sternum to the outside, until the correct position.
This is a very painful surgery, for which reason it is necessary to remain hospitalized especially to receive intravenous analgesics and improve comfort, and the patient is discharged both ready and in pain, there is lessened and no complications exist. .
How is the recovery
During the period after discharge, it is necessary to attend frequent consultations with the doctor to perform radiography or computerized tomography, with the purpose of evaluating if the sternum continues in the correct position. With these evaluations, it is also possible to determine which is the best time to remove the surgical material or the metal bar placed during the surgery.
In the case of open surgery, the material must be removed after 6 to 12 months; while the minimally invasive surgery bar is removed from 2 or 3 years only.
During this period, it is also important to be aware of signs of infection, the rejection of the surgical material placed in the body, such as swelling or reddening in the area of the cuts, fever above 38 ºC or excessive fatigue, for example.
On the other hand, sports activities can only start with the approval of the doctor, in order to avoid them from greater physical impact and greater risk of injuries, such as football, ballroom or martial arts.
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