Pectus excavatum coexisting with straight back syndrome in children: A five-case series

Background Pectus excavatum (PE) and straight back syndrome (SBS) are chest wall deformities that reduce thoracic volume and compress mediastinal structures through different mechanisms. When both conditions occur together, cardiovascular and respiratory risk may increase, yet little is known about when to intervene in children who have both. Case series Case 1: A 12-year-old girl with PE ( Haller index 5.2) and SBS presented with dyspnea, palpitation, and dysphagia; she underwent minimal invasive repair of pectus excavatum (MIRPE) with X-configuration bars and showed symptoms improvement at 6 months. Case 2: A 10-year-old girl with PE ( Haller index 3.2) and SBS presented with effort intolerance; she was treated with vacuum bell therapy but showed minimal improvement due to non-compliance. Case 3: A 13-year-old boy with PE and SBS presented with psychosocial complaints; he underwent MIRPE with XI-configuration bars and reported improved self-esteem at 3 months. Case 4: A 10-year-old asymptomatic girl with PE ( Haller index 4.2) and SBS underwent MIRPE with X configuration bars; she had improved exercise endurance at 8 months. Case 5: An 11-year-old boy with PE and SBS presented with effort intolerance and palpitation; he underwent MIRPE with Parallel-configuration bars and showed symptom resolution at 9 months. Conclusion In pediatric patients with PE coexisting with SBS, MIRPE can achieve satisfactory chest wall correction and symptomatic improvements while also improving the anteroposterior thoracic dimension reduced by the underlying SBS.