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Extra-Thoracal Migration of the Nuss Bar: A Very Rare Late Complication
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A3519 - Extra-Thoracal Migration of the Nuss Bar: A Very Rare Late Complication
Author Block: N. L. Simon1, S. Kolvekar2, A. Khosravi2; 1GKT School of Medical Education, London, United Kingdom, 2Department of Cardiothoracic Surgery, Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom.
Pectus excavatum (PE) is a chest wall deformity with an incidence of around 1 in 400 live births. The deformity affects the anterior chest wall and is caused by abnormal growth of the sternum and adjacent ribs producing a concave appearance of the chest. Patients with PE often complain of dyspnea, fatigue and exercise intolerance. In severe cases, cardiac compression is reported. Surgical correction is one option for these patients and minimally invasive surgical techniques are becoming the most favorable option. The Nuss procedure aims to restore functional integrity by the insertion of one or two stainless steel bars behind the sternum. These bars will lift the deformity and be stabilized for a period of two to three years before their removal. The Nuss procedure is a well-established corrective procedure with few reported complications and a high success rate.
We report the first case of bar migration into the stomach necessitating further surgical intervention for removal.
Our case presents a rare complication of pectus excavatum repair, but highlights the importance of vigilant follow-up in these patients. If pectus migration does occur, imaging in the form of x-ray and CT scans may be of use in early detection of such a complication in order to expedite management.
Author Block: N. L. Simon1, S. Kolvekar2, A. Khosravi2; 1GKT School of Medical Education, London, United Kingdom, 2Department of Cardiothoracic Surgery, Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom.
Pectus excavatum (PE) is a chest wall deformity with an incidence of around 1 in 400 live births. The deformity affects the anterior chest wall and is caused by abnormal growth of the sternum and adjacent ribs producing a concave appearance of the chest. Patients with PE often complain of dyspnea, fatigue and exercise intolerance. In severe cases, cardiac compression is reported. Surgical correction is one option for these patients and minimally invasive surgical techniques are becoming the most favorable option. The Nuss procedure aims to restore functional integrity by the insertion of one or two stainless steel bars behind the sternum. These bars will lift the deformity and be stabilized for a period of two to three years before their removal. The Nuss procedure is a well-established corrective procedure with few reported complications and a high success rate.
We report the first case of bar migration into the stomach necessitating further surgical intervention for removal.
Our case presents a rare complication of pectus excavatum repair, but highlights the importance of vigilant follow-up in these patients. If pectus migration does occur, imaging in the form of x-ray and CT scans may be of use in early detection of such a complication in order to expedite management.
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