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Thoracic outlet syndrome (TOS): A case report of a rare complication after Nuss procedure for pectus excavatum. 2018

Weiqiang Zhang, and Yingxin Pei, and Keqiang Liu, and Jian Tan, and Jingbo Ma, and Jing Zhao
Department of Thoracic Surgery, PLA Army General Hospital, Beijing, China.

BACKGROUND The Nuss procedure has become a major alternative operation for patients with pectus excavatum (PE). METHODS We report a case of 27-year-old man with PE who developed thoracic outlet syndrome (TOS) after the Nuss procedure. The patient showed clinical symptoms of brachial plexus compression. METHODS Further evaluation demonstrated a narrowed space between the first rib and the anterior scalene muscle and compressing the brachial plexus and vessels. METHODS Nerve nourishing medicine and rehabilitation exercising were taken to restore the muscle strength. RESULTS Several months later, the clinical symptoms disappeared. CONCLUSIONS Medicine and rehabilitation exercising may benefit the functional recovery of impaired nerve in TOS in the early stage of TOS.

UI MeSH Term Description Entries
D008297 Male Males
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D005660 Funnel Chest A developmental anomaly in which the lower sternum is posteriorly dislocated and concavely deformed, resulting in a funnel-shaped thorax. Pectus Excavatum,Chest, Funnel,Chests, Funnel,Excavatum, Pectus,Funnel Chests
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013901 Thoracic Outlet Syndrome A neurovascular syndrome associated with compression of the BRACHIAL PLEXUS; SUBCLAVIAN ARTERY; and SUBCLAVIAN VEIN at the superior thoracic outlet. This may result from a variety of anomalies such as a CERVICAL RIB, anomalous fascial bands, and abnormalities of the origin or insertion of the anterior or medial scalene muscles. Clinical features may include pain in the shoulder and neck region which radiates into the arm, PARESIS or PARALYSIS of brachial plexus innervated muscles, PARESTHESIA, loss of sensation, reduction of arterial pulses in the affected extremity, ISCHEMIA, and EDEMA. (Adams et al., Principles of Neurology, 6th ed, pp214-5). Costoclavicular Syndrome,Neurovascular Syndrome, Thoracic Outlet,Scalenus Anticus Syndrome,Thoracic Outlet Nerve Compression Syndrome,Aperture Syndrome, Thoracic Outlet,Arterial Thoracic Outlet Syndrome,Nerve Compression Syndrome, Thoracic Outlet,Neurogenic Thoracic Outlet Syndrome,Neurologic Syndrome, Thoracic Outlet,Superior Thoracic Aperture Syndrome,Thoracic Outlet Neurologic Syndrome,Thoracic Outlet Neurovascular Syndrome,Thoracic Outlet Syndrome, Neurogenic,Venous Thoracic Outlet Syndrome,Costoclavicular Syndromes,Outlet Syndrome, Thoracic,Outlet Syndromes, Thoracic,Syndrome, Costoclavicular,Syndrome, Scalenus Anticus,Syndrome, Thoracic Outlet,Syndromes, Costoclavicular,Syndromes, Thoracic Outlet,Thoracic Outlet Syndromes
D019060 Minimally Invasive Surgical Procedures Procedures that avoid use of open, invasive surgery in favor of closed or local surgery. These generally involve use of laparoscopic devices and remote-controlled manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device. Minimal Access Surgical Procedures,Minimal Surgical Procedures,Minimally Invasive Surgical Procedure,Surgical Procedures, Minimally Invasive,Minimal Surgical Procedure,Minimally Invasive Surgery,Procedure, Minimal Surgical,Procedures, Minimal Access Surgical,Procedures, Minimal Surgical,Procedures, Minimally Invasive Surgical,Surgical Procedure, Minimal,Surgical Procedures, Minimal,Surgical Procedures, Minimal Access,Minimally Invasive Surgeries,Surgeries, Minimally Invasive,Surgery, Minimally Invasive

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