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Epidemiology, presentation and aspirations in Pectus carinatum: a retrospective cohort study
Georgina M Bough1, Lorna Johnston2, Christina Major3
1Department of Paediatric Surgery, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK. g.bough@nhs.net.
Insights
This study of 430 children with pectus carinatum found significant differences in presentation between boys and girls. Detailed clinical documentation is crucial for understanding this chest wall deformity.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Medical Genetics
Background:
- Pectus carinatum is a congenital chest wall deformity characterized by anterior protrusion of the sternum and ribs.
- Understanding its epidemiology and clinical presentation is vital for effective management.
- Previous studies have highlighted variations in presentation, but comprehensive data on pediatric populations remain essential.
Purpose of the Study:
- To delineate the epidemiology and clinical characteristics of pediatric pectus carinatum.
- To assess the outcomes of initial hospital clinic appointments for affected children.
- To identify potential sex-based differences in presentation and family history.
Main Methods:
- Retrospective cohort study involving 430 children diagnosed with pectus carinatum between 1998 and 2022.
- Data collection included demographic information and clinical details extracted from medical records.
- Analysis focused on age at presentation, sex, symptoms, family history, and chest wall morphology.
Main Results:
- The cohort comprised 364 boys and 66 girls, with asymmetry identified at a median age of 11 years.
- Girls presented earlier (median 10 vs. 14 years), were more likely to report pain (44% vs. 26%), and had a higher incidence of family history (33% vs. 20%).
- Most cases (69%) were asymmetrical isolated carinatum, predominantly right-sided; mixed carinatum/excavatum deformities were typically left-sided.
Conclusions:
- Pectus carinatum exhibits a heterogeneous clinical presentation with notable sex-based disparities.
- Comprehensive clinical documentation, including detailed morphology and context, is necessary for accurate phenotyping and outcome comparison.
- Standardized recording of clinical findings is essential for advancing research on chest wall deformities.
Purpose:
To describe the epidemiology and clinical presentation of children with pectus carinatum; and the outcome of their first hospital clinic appointment.
Methods:
A single surgeon, retrospective cohort study of children presenting between 1998 and 2022. Demographic and clinical data were collected from the medical record.
Results:
We present 430 children with pectus carinatum; 364 boys and 66 girls. Their asymmetry was identified at a median age of 11 years (range 0-16 years). Girls developed carinae earlier than boys (10 vs 14 years, p = 0.003), were more likely to present with pain (44% vs 26%, p = 0.041) and were more likely to have a family history of chest wall deformity (33% vs 20%, p = 0.070). The majority (342, 69%) had an asymmetrical, isolated carinatum. Isolated carinae were mainly right dominant (174, 57%), conversely, mixed carinatum/ excavatum were typically left side dominant (10/15 vs 2/15, p = 0.008).
Conclusion:
The clinical presentation of carinatum is heterogenous with apparent differences between males and females. A detailed history and examination are required; if clinicians record, in detail, the clinical context and morphology of the carinatum, a comparison of phenotype and outcome would become feasible. Simply stating "Carinatum" is not enough.
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