Chest wall anomalies • Congenital chest wall anomalies fall into 2 groups: • Those with overgrowth of the rib cartilages causing either a depression or protuberance • Those with varying degree of either aplasia or dysplasia Pectus excavatum • Pectus excavatum = funnel chest a depression of the anterior chest wall. • The incidence of funnel chest is 1 in 1000 live births with 3:1 male-female predominance. • All variations of depth, symmetry, and breadth of the deformity depth and extent of depression determine the degree of cardiac and pulmonary compression. • The deformity frequently is noted at birth and progresses with growth. Pectus carinatum • Pectus carinatum protussion deformity of chest wall occurs less frequently than pectus excavatum (15%). • The prominence may be in the sternal manubrium chondromanubrial deformity or pigeon breast. • The most common protrusion occurs in the lower or body of the sternum chondrogladiolar or chicken breast. Poland’s syndrome • Poland’s syndrome a spectrum of anomalies that include the absence of the pectoralis major and minor muscle along with a complex of hand anomalies including syndactyly, brachydactyly or ectrodactyly, deformed or absent ribs, absence of axillary hair and decreased amount of subcutaneous fat. • Abnormal migration of the embryonic tissue forming the pectoralis muscle, hypoplasia of the subclavian artery or intrauterine injuries may be responsible. • Associated with sporadic occurrence in 1:30000 live births. Chest Trauma
