Pectus carinatum
Pigeon breast; Pigeon chest
Pectus carinatum is present when the chest protrudes over the sternum. It is often described as giving the person a bird-like appearance.
The ribs connect on the front of the chest with the long flat sternum, or breast bone, and on the back with the vertebral column, creating a cage of protection for the lungs and heart.
A bowed chest is also called pectus carinatum. It is a protrusion of the chest over the sternum often described as bird-like. Pectus carinatum is usually only a cosmetic defect but can be associated with other genetic diseases.
Considerations
Pectus carinatum may occur alone or along with other genetic disorders or syndromes. The condition causes the sternum to protrude. There is a narrow depression along the sides of the chest. This gives the chest a bowed-out appearance similar to that of a pigeon.
People with pectus carinatum generally develop a normal heart and lungs. However, the deformity may prevent these from functioning as well as they could. There is some evidence that pectus carinatum may prevent complete emptying of air from the lungs in children. These young people may have less stamina, even if they do not recognize it.
Pectus deformities can also have an impact on a child's self-image. Some children live happily with pectus carinatum. For others, the shape of the chest can damage their self-image and self-confidence. These feelings may interfere with forming connections to others.
Causes
Causes may include:
- Congenital pectus carinatum (present at birth)
- Trisomy 18
- Trisomy 21
- Homocystinuria
- Marfan syndrome
- Morquio syndrome
- Multiple lentigines syndrome
- Osteogenesis imperfecta
In many cases the cause is unknown.
Home Care
No specific home care is needed for this condition.
When to Contact a Medical Professional
Contact your health care provider if you notice that your child's chest seems abnormal in shape.
What to Expect at Your Office Visit
Your provider will perform a physical exam and ask questions about your child's medical history and symptoms. Questions may include:
- When did you first notice this? Was it present at birth, or did it develop as the child grew?
- Is it getting better, worse, or staying the same?
- What other symptoms are present?
Tests that may be done include:
- Lung function testing to measure how well the heart and lungs are performing
- Lab tests such as chromosome studies, enzyme assays, x-rays, or metabolic studies
A brace may be used to treat children and young adolescents. Surgery is sometimes done. Some people have gained improved exercise ability and better lung function after surgery.
References
Boas SR. Skeletal diseases influencing pulmonary function. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 445.
Gottlieb LJ, Reid RR, Slidell MB. Pediatric chest and trunk defects. In: Rodriguez ED, Losee JE, Neligan PC, eds. Plastic Surgery: Volume 3: Craniofacial, Head and Neck Surgery and Pediatric Plastic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 40.
Kelly RE, Martinez-Ferro M. Chest wall deformities. In: Holcomb GW, Murphy JP, St. Peter SD, eds. Holcomb and Ashcraft's Pediatric Surgery. 7th ed. Philadelphia, PA: Elsevier; 2020:chap 20.
Wald O, Izhar U, Sugarbaker DJ. Lung, chest wall, pleura and mediastinum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 58.
Version Info
Last reviewed on: 7/1/2023
Reviewed by: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
