Sharing a Case of Severe PE with Rib Flare
Here is one of those classic cases we came across in late September.
This time, it was a 13-year-old boy who’s been living with pectus excavatum since he was little. At first, it wasn’t a big deal—just a subtle dip in his chest that his family was keeping an eye on. But as he grew, things started to shift. By around age 10, his chest was noticeably more sunken, and he began feeling tightness and shortness of breath during any activity. It was tough on him, and that’s when his family decided it was time to get some help.
During the initial exam, it was clear his chest wall was deeply sunken, and we noticed rib flaring, especially on the left side. Imaging confirmed our worries: his heart was getting compressed, showing this was a serious case of pectus excavatum with rib flare. His family was anxious but determined to get him back to a healthy, active life.
After some careful prep, we went ahead with surgery under general anesthesia. We made small incisions on each side of his chest and used the Wung procedure to lift and support his chest wall. To tackle the rib flare, we applied a technique called pre-shaping just before putting in the bar, which really helped manage the flaring. The surgery took about an hour, and the outcome was beyond what we’d hoped for—it was a total game changer for him.
Surgery for severe pectus excavatum can be challenging, especially when rib flare is involved. The classic Nuss procedure doesn’t always give us the results we’re looking for, which is why our team usually opts for the Wung procedure in complex cases like this one. Tackling that rib flare is also a crucial part of the treatment. In this case, the pre-shaping technique worked wonders. It’s pretty straightforward, but it really makes a big difference in shaping the chest wall just right before we insert the bar.
This young man can now look forward to a future where he can breathe freely and embrace life without the limitations that pectus excavatum brought him—and he’s already been discharged!
PS： The pictures and details have all been approved for sharing by the patient.