Radiographic findings after pectus excavatum repair
L Lancaster1, J McIlhenny, B Rodgers
1Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Insights
Postoperative chest X-rays in children after pectus excavatum repair show common changes like atelectasis and pleural effusions. Despite concerning radiographic findings, patients typically experience good clinical outcomes.
Area of Science:
- Pediatric Surgery
- Thoracic Imaging
- Cardiothoracic Radiology
Background:
- Pectus excavatum is a congenital chest wall deformity requiring surgical correction.
- Radiographic findings following pectus repair are not well-documented.
- Understanding postoperative imaging is crucial for accurate interpretation.
Purpose of the Study:
- To describe the spectrum of postoperative radiographic changes after pectus excavatum repair in children.
- To correlate radiographic findings with clinical outcomes.
Main Methods:
- Retrospective review of chest radiographs from 65 children.
- Surgical repair of pectus excavatum performed between 1985 and 1992.
- Analysis of common postoperative imaging abnormalities.
Main Results:
- Atelectasis (n=64) and pleural effusions (n=38) were the most frequent findings.
- Other observed changes included congestion/edema (n=30), pneumothorax (n=12), fixation strut abnormalities (n=21), and pneumomediastinum (n=4).
- Despite these radiographic abnormalities, all patients demonstrated positive clinical recovery.
Conclusions:
- Postoperative chest radiographs in pediatric pectus excavatum repair frequently exhibit various abnormalities.
- These radiographic findings, while potentially alarming, do not necessarily indicate clinical complications.
- Radiologists and surgeons should be aware of these common changes to avoid misinterpretation.
Abstract:
Postoperative radiographic changes after pectus repair have not previously been described. We reviewed the chest radiographs of 65 children who underwent surgical repair of pectus excavatum between early 1985 and mid-1992. After operation, 64 children showed atelectasis, 38 had pleural effusions, 30 showed a congestion or edema pattern, 12 had pneumothorax, 21 showed fixation strut tilt or rotation, and 4 had pneumomediastinum. Despite the sometimes worrying radiographic appearance, these children uniformly did well clinically.
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