Pigeon breast

Japanese: 鳩胸

(2) Pigeon chest (pectus carinatum, pigeon chest)
It is said to occur less frequently than pectus excavatum, at around one-tenth the frequency. It is rarely seen in infancy, and as the costal cartilage grows, the sternum protrudes forward, and it is often discovered after the child enters school. Morphologically, it is classified into two types: keeled pigeon breast, in which the sternum protrudes more strongly in the middle and lower parts than in the upper part, and is most prominent near the xiphoid process, and pouter pigeon breast, in which the entire sternum protrudes and is accompanied by a depression from the middle to lower part of the sternum. Compared to pectus excavatum, there is no compression of the heart or lungs, and functional abnormalities are rarely a problem.
Treatment is similar to that for pectus excavatum. In children, sternal drop surgery is performed. The costal cartilage at the attachment point to the ribs is removed, the sternum is lowered inwards and re-suturing. In adults, sternal rotation surgery is performed as the mobility of the sternum and ribs is reduced. In cases where the heart has become stuck in the protruding part, care must be taken as there are cases where the heart is compressed after surgery and heart failure develops. [Suya Akihisa, Isobe Takeshi]

Source : Internal Medicine, 10th Edition About Internal Medicine, 10th Edition Information

Japanese:

（2）鳩胸（pectus carinatum，pigeon chest）
　漏斗胸に比べ頻度は低く，1/10程度といわれている．乳幼児期に認めることは少なく，肋軟骨の成長とともに胸骨が前方に突出し，就学期以降に発見されることが多い．形態学的に，胸骨の突出がその上部よりも中部，下部と強くなり，剣状突起近傍が最も突出するkeeled pigeon breast，胸骨全体の突出に，胸骨中部から下部にかけての陥凹を伴うpouter pigeon breastの2型に分類される．漏斗胸に比べ，心臓や肺の圧迫はなく，機能的な異常が問題になることは少ない．
　治療は漏斗胸に準じて行われる．小児期では胸骨下降術を行う．肋骨付着部の肋軟骨を切除し胸骨を内側におろし再縫合する．成人では胸骨や肋骨の可動性が減少しているので胸骨翻転術を行う．心臓が突出部にまではまり込んでいるような症例では，術後心臓を圧迫し心不全を発症する症例もあり注意が必要である．［須谷顕尚・礒部　威］

出典　内科学第10版内科学第10版について　情報

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