Children's Hospital Colorado

Pectus Carinatum

What is pectus carinatum?

Pectus carinatum, also known as pigeon chest, is a condition in which the chest sticks out farther than normal. The result is a chest that is bowed shape with the breastbone (sternum) and associated ribs pointing outward. The condition can be on both sides of the chest or just one side.

In addition to the physical appearance, children may also experience low self-esteem, a lack of self-confidence and other social challenges.

What causes pectus carinatum?

Pectus carinatum happens when too much cartilage grows around the breastbone (sternum) and ribs causing the chest to get pushed outward. It is not usually linked to any other health problems, but sometimes can be seen with spinal curve problems and connective tissue disorders. Children typically develop this condition during periods of rapid growth.

Who gets pectus carinatum?

Pectus carinatum is much more common in boys and may run in families. Some people have the condition at birth, while most people notice the condition during growth spurts in the adolescent and teen years. Patients who develop pectus carinatum tend to be relatively tall and thin.

What are the symptoms of pectus carinatum?

Other than the cosmetic or physical appearance, kids with pectus carinatum may not show any other signs. 

Symptoms may include chest pain that worsens with activity or direct contact. The pain may become severe enough to restrict activity or even cause discomfort when lying on the stomach.

What tests are used to diagnose pectus carinatum?

At Children's Hospital Colorado, patients meet with a care team that includes a pediatric general surgeon who specializes in treating chest wall deformities. After a review of your child's medical history and a physical evaluation of his or her chest wall, the care team may also choose to run one or more of the following tests: 

  • A chest X-ray, which shows a picture of the chest, heart and lungs.
  • Computed tomography (CT scan), which shows what is happening on the inside of the chest and can demonstrate underlying changes to the heart and lungs.
  • Additional tests based on the severity of the condition.

How is pectus carinatum treated?

Treatment for pectus carinatum starts with bracing.

Chest wall treatment specialists at Children's Colorado believe in providing patients with the safest and most effective treatment methods, starting with non-surgical options. Using a pectus carinatum brace is a good treatment for most patients under 17 years old because the chest wall is still flexible. Your child will wear an adjustable brace that goes around the chest, putting pressure on the outside to slowly flatten the cartilage.

Wearing the brace:

The pectus carinatum brace will need to be worn for one to two years, or until your child is fully grown. Your child will start wearing the brace for a few hours a day and work up to wearing the brace for 12 to16 hours a day.

After a significant correction is obtained, which can take longer than a year, your child can start wearing the brace for fewer hours a day but will still need to wear it to keep the chest from pushing out again.

Pectus carinatum surgery:

If bracing doesn't work, your child's condition is more severe, or if he or she is too old for bracing, pectus carinatum surgery is an option. The surgery includes removing the extra cartilage around the breastbone (sternum).

This procedure requires a four to five day hospital stay. Your child will have activity restrictions in place after the surgery until the cartilage grows back, which takes approximately six months.

Why choose Children's Colorado for your child's pectus carinatum treatment?

We specialize in pectus carinatum treatment.

Our pediatric care team is one of the most experienced teams in the Rocky Mountain Region specializing in chest wall deformity treatment. Patients and families are supported by a team of experts dedicated to caring for kids and teens before, during and after surgery including:

  • Pediatric surgeon
  • Pediatric anesthesiologist
  • Physical therapist
  • Pediatric nurses
  • Pediatric radiologists

When surgery is recommended, our families can rest assured knowing that we offer:

  • Anesthesiologists who are specialized in keeping kids safe and pain-free during surgery
  • Kid-sized equipment, from radiology imaging to the operating room
  • Age-appropriate information about what to expect from surgery for patients and siblings
  • Collaboration and communication with your primary care doctor to ensure a smooth transition after surgery

Learn more about Pediatric Surgery at Children's Colorado.

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