Source: Annual Congress 2008 - Mediastinal lesions; rare pathology
Disease area: Paediatric lung diseases, Thoracic oncology

Abstract

INTRODUCTION: The sternal cleft is a rare congenital deformity of the thoracic wall and consists in a complete or incomplete separation of sternal bars, the reason why it is wrongly known as sternal agenesis. It can be associated to heart defects, facial haemangiomas and omphalocele. The surgical correction is still indicated in the newborn period, when the sternal borders are more flexible and they can be easily and directly approximate.
CASE REPORT: A non-full-term infant boy was born following a complicated pregnancy by a cesarian section delivery. He was found to have an obvious ²U² shaped deformity of the chest wall with widely spaced rib ends anteriorly separated by thin translucent skin through which cardiac pulsations could be easily appreciated. No other abnormalities but chest haemangiomas were detected at physical examination. The child was immediately directed for our service. After evaluation it was opted to wait the healing of the cutaneous chest membrane. At 7 months of birth the primary closure of the cleft was performed, making a wedge section in the sternum bridge and bilateral sliding chondrotomies, allowing the sternal bars to be freed up and moved medially into position to be fixed. Any hemodynamic or respiratory alteration were evidenced during the correction. Patient developed well, discharged in the 3rd post operative.
CONCLUSION: The sternal cleft is a rare deformity and the surgical correction should be precocious advised because vital mediastinal structures must be prevented from direct trauma and moreover the appearance of a child hearts bulgining through the chest wall can be very disturbing to parents.

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Citations should be made in the following way:
D. C. Cataneo, E. N. Hasimoto, C. A. Polonio, A. J. M. Cataneo (Botucatu/Sao Paulo, Brazil). ²U² shaped sternal cleft: case report. Eur Respir J 2008; 32: Suppl. 52, 2149

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