Minimally invasive repair of pectus carinatum using the Abramson technique

In the past, the treatment of pectus carinatum has been managed by open, invasive surgical procedures, which involved the resection of cartilage growth plates (Ravitch procedure). By preventing normal bony growth and maturity, this technique often led to postoperative complications, such as acquired thoracic dystrophy, chronic pain and scarring, and stiffness of the whole anterior chest. Dyspnea and exercise intolerance due to restricted thoracic space and cardiac compression were not uncommon as well. Over the last 2 decades, nonsurgical and minimally invasive approaches have gained ground because it was recognized that simple sternal compression was able to remodel the elastic anterior chest wall and therefore correct pectus carinatum adequately/efficiently, at least in children. However, failure of this compressive brace treatment is not uncommon in adolescents and older patients. Abramson therefore developed a minimally invasive technique for the correction of pectus carinatum using a pectus bar that is placed anteriorly to the sternum. The procedure is less invasive and less risky than a pectus bar inserted for pectus excavatum, but the lateral fixation of the pectus bar in the Abramson procedure remains a challenge. We demonstrate the technical aspects of the procedure step by step including our solution for fixation of the stabilizers.

THE CASE OF JEUNE SYNDROME AMONG THE PRECARPATHIAN POPULATION

Despite the fact that Jeune syndrome is rather rare, neonatologists and pediatricians need to be aware of this pathology. This will facilitate early diagnostics of the condition and aid in the choice of the most adequate algorithms for its monitoring and treatment. The aim: To describe the case of Jeune syndrome among the Precarpathian population. Infant patient with Jeune syndrome and relevant medical records. Methods used in the study: clinical-genealogical and syndromal analysis, general clinical examination, radiologic method, including computed tomography (CТ) scan with 3D image reconstruction, methods of ultrasound diagnostics. The study was conducted in accordance with the Declaration of Helsinki Ethical Principles. The newborn baby was diagnosed with asphyxiating thoracic dystrophy on the basis of personal observation and conducted complex examination. According to the literature, this syndrome is rarely diagnosed in this age group. The diagnosis was based on the clinical and phenotypic manifestations of the syndrome, primarily on the characteristic association of symptoms of specific chest deformity and severe respiratory failure with oxygen dependence in the patient. Skeletal and pulmonary changes on radiographs and computed tomography scans were rather indicative. Brief follow-up data on the patient at the age of nine months are given.

Overlapping Holoprosencephaly-polydactyl syndrome and Asphyxiating thoracic dystrophy, an incidental finding in prenatal ultrasound screening: A rare case report

An obstetric ultrasound of a multi-gravid mother at 37-week of gestation showed a female fetus with alobar holoprosencephaly, polydactyly, short ribs, narrow chest and short upper and lower extremity bones, consistent with Holoprosencephaly-polydactyly syndrome and Asphyxiating thoracic dystrophy overlap. Apgar score was 0 in the first and fifth minutes.

Prenatal case of detection of the asphyxiating thoracic dystrophy (Jeune syndrome)

Асфиктическая дисплазия грудной клетки представляет собой редкое аутосомно-рецессивное наследственное заболевание, которое характеризуется узкой грудной клеткой, короткими рёбрами, укороченными трубчатыми костями, возможно сочетание этих симптомов с полидактилией, аномалиями мозга, сердца, почек, печени, поджелудочной железы. В статье представлен случай пренатального выявления синдрома асфиктической дисплазии грудной клетки (синдром Жене) Short-rib thoracic dysplasia (SRTD) is an autosomal recessive disorder characterized by a constricted thoracic cage, short-ribs, shortened tubular bones, polydactyly is variably present. The visceral malformation can include anomalies brain, heart, kidneys, liver, pancreas. We present a case report of prenatally diagnosed Short-rib thoracic dysplasia (SRTD) syndrome.