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Updated: Aug 14, 2026

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
A life-threatening complication of the Nuss procedure for pectus excavatum
Tom N Hoel1, Kjell Arne Rein, Jan L Svennevig
1Department of Thoracic and Cardiovascular Surgery, Rikshospitalet University Hospital, Oslo, Norway. tom.nilsen.hoel@rikshospitalet.no
Abstract:
We describe a delayed, life-threatening complication in a boy operated on using the Nuss-procedure 2 months earlier. On admittance he was in shock with cardiac tamponade. An immediate needle aspiration of blood from the pericardium was done before a median sternotomy. The Nuss-bar was removed, and we identified a 1.5-cm laceration in the adventitial layer of the ascending aorta as the source of bleeding. The tear was closed, and the patient had an uneventful recovery. Careful positioning of the bar is necessary to avoid complications. Measures must be taken postoperatively to confirm that the steel bar does not rotate.
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