20 Apr 2021
Hoan My Sai Gon Hospital recently successfully treated a patient with a rare condition called ‘chest wall disorder’ using a metal bar. The patient is Mr. L.H.K, currently living in Ca Mau.
The disorder is difficult to detect in infants
According to doctors, chest wall disorder (pectus excavatum), also known as ‘sunken chest syndrome’ and ‘funnel chest’, is a deformity caused by the unusual growth of several ribs and sternums, making the chest cave in. This is a congenital deformity that is difficult to detect in infants and is more frequently seen in males than in females. Symptoms of the chest caving in will be easier to see as the child grows and reaches puberty.
In an interview with a reporter from Law and Life magazine, Mr. K’s mother shared that: “When my son was 16, I found that his chest had completely sunken in, but there were no clear symptoms when he was 3-4”.
When he reached 18, Mr. K frequently experienced exhaustion and aches when exerting himself, and upon the doctors’ advice, he decided to undergo pectus excavatum repair surgery using metal bars at Hoan My Sai Gon Hospital.
A second degree specialist, Doctor Thong Minh Cao from the Thoracic Cardiology Department clarified that: “In recent years, to effectively treat pectus excavatum, improve body aesthetics and prevent complications to overall health caused by the disorder, doctors started using a method called pectus excavatum repair surgery, a method involving a metal bar (the Nuss method). The metal bar will raise and stabilise the ribcage utilising endoscopic surgery. After the operation, the chest will take a normal shape instead of being sunken in.
Doctor Thong Minh Cao further explained that if the sternum goes too far inward, it will result in certain complications inhibiting the functions of the patient’s heart and lungs. People who suffer from sunken chest syndrome experience symptoms such as shortness of breath and a tight chest, and the deep chest dent may cause patients to lose confidence during daily life and communication, quickly deteriorating their mental and physical health.
In serious cases of pectus excavatum, the heart and lungs are squeezed due to the dent putting pressure on the heart, moving it out of position, and severely affecting respiratory functions due to the limited volume of the chest. The chest cannot expand enough, and therefore cannot provide the air volume needed for the lungs to operate, ultimately reducing the air intake of the patient.
In Mr. K’s situation, more than two years since the initial pectus excavatum repair, doctors proceeded to perform surgery and remove the metal bar used to raise the chest. Mr. K is in perfectly fine health after the bar removal surgery, but he still needs to refrain from strenuous physical activities.
After his surgery, Mr. K’s chest dent completely disappeared, and his chest has now healed and has a round, normal shape without having to rely on the metal bar like before. The successful treatment has helped Mr. K take his life back, regain confidence and become more optimistic.
According to doctor Thong, chest wall disorder cannot naturally heal itself and tends to get worse with time, especially during puberty when the bones and cartilage harden fast. Doctor Thong advises parents to take their children to the hospital as soon as they see unusual symptoms in their child’s chest, to avoid health complications caused by sunken chest syndrome.
Recognisable symptoms are when children complain about pain in the costal cartilage or anticardium areas after doing physically demanding activities. Other symptoms also include anxiety due to atrial arrhythmia or when the child finds it hard to breathe. Specialist doctors can diagnose the disorder by recognising the apex of the heart being shifted to the left, or a deep bowl-shaped dent, or a wide shallow dent.
Pectus excavatum will continue to worsen when the patient reaches puberty. Therefore, it is necessary to perform the surgery in time, to ensure the heart and lungs can perform their functions safely. Doctors are concerned about children being misdiagnosed and incorrectly treated due to certain areas being underdeveloped in medical knowledge, causing the patients to suffer from sunken chest syndrome for a long time. Untreated, the body cannot continue to grow due to pressure on the heart and lungs. Some places even diagnose the dangerous syndrome as rickets or malnourishment. As such, patients need to get checked out at hospitals with specialists and modern medical equipment.
Rare chest wall disorder in all 4 family members
Not long ago, while teaching pectus excavatum repair methods to doctors at Da Nang General Hospital, doctors at the University of Medicine and Pharmacy and the University of Medicine and Pharmacy’s Hospital performed surgery on a family in which all 4 members suffered from pectus excavatum.
The family consisted of Mr. B.T.H (aged 43) and his 3 daughters T.T.N.H (aged 19), C.T.N.H (aged 16), and T.T.N.H (aged 13). According to doctors, it is extremely rare for 4 members of the same family to suffer from this syndrome. Congenital pectus excavatum is frequently seen in the population, with a rate of 1 out of 263 babies born. The syndrome has long been acknowledged, but the cause remains unknown. Scientists have confirmed that the syndrome is genetic but have yet to pinpoint the relevant gene. In global medical literature, the family with the highest number of members inflicted with pectus excavatum cases is three people.