title: Intra-abdominal pectus bar migration--a rare clinical entity: case report.
abstract: We present the case of a 20-year-old male who underwent successful surgical correction of pectus excavatum with the Highly Modified Ravitch Repair (HMRR). At 29 months the attempted operative removal of the Ravitch bar was unsuccessful despite the impression of adequate bar location on chest x-ray. Subsequent imaging with computed tomography was unclear in determining whether the bar was supra or infra-diaphragmatic due to the tissue distortion subsequent to initial surgery. Video assisted thoracoscopic surgery (VATS) successfully retrieved the bar and revealed that it was not in the thorax, but had migrated to the intra-abdominal bare area of the liver, with no evidence of associated diaphragmatic defect or hernia. Intra-abdominal pectus bar migration is a rare clinical entity, and safe removal can be facilitated by the use of the VATS technique.
authors.affiliation: Department Biosurgery and Surgical Technology, Imperial College London, St Mary's Hospital, London W21NY, UK. rtahmassebi@doctors.org.uk
authors.forename: Ramon
authors.initials: R
authors.lastname: Tahmassebi
authors.forename: Hutan
authors.initials: H
authors.lastname: Ashrafian
authors.forename: Caner
authors.initials: C
authors.lastname: Salih
authors.forename: Ranjit P
authors.initials: RP
authors.lastname: Deshpande
authors.forename: Thanos
authors.initials: T
authors.lastname: Athanasiou
authors.forename: Julian E
authors.initials: JE
authors.lastname: Dussek
mesh_terms: D034841:Abdominal Cavity; D000328:Adult; D020878:Device Removal; D004868:Equipment Failure; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D008297:Male; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects* / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed