Cottalorda J, Stephan J L, Varlet F, Maatougui K, Chavrier Y
Service de Chirurgie Infantile, Hôpital Nord, Saint-Etienne.
Rev Chir Orthop Reparatrice Appar Mot. 1998 Oct;84(6):563-6.
The authors report 2 cases of internal costal exostosis in children.
Case 1: A 15-year-old boy with hereditary multiple exostosis presented for chest pain. Radiograph and CT scan showed an internal rib exostosis. It was removed by thoracotomy. Eighteen months later, the child was painfree. Case 2: An-11-year old boy presented with fever and a headache. A chest radiograph showed an image of pulmonary opacity interpreted as a pneumonia. The child was admitted for antibiotic therapy. Two months later, X-ray lesion persisted and a CT-scan was obtained. It showed a solitary costal internal exostosis which was removed by thoracotomy. At 12 months follow-up, he was asymptomatic.
Internal costal exostosis can induce some complications such as hemothorax, diaphragmatic or pericardic wounds. In case of symptomatic exostosis, the authors recommend a surgical removal to avoid severe complications. If the exostosis is asymptomatic, abstention can be recommend. As a matter of fact, hemothorax, for instance, can occur even due to a round and smooth exostosis without any history of trauma.
作者报告2例儿童肋内骨外生骨疣病例。
病例1：一名患有遗传性多发性骨外生骨疣的15岁男孩因胸痛前来就诊。X线片和CT扫描显示肋内骨外生骨疣。通过开胸手术将其切除。18个月后，该患儿无疼痛症状。病例2：一名11岁男孩出现发热和头痛症状。胸部X线片显示肺部有模糊影像，被诊断为肺炎。该患儿因抗生素治疗入院。两个月后，X线病变仍然存在，遂进行CT扫描。结果显示为孤立性肋内骨外生骨疣，通过开胸手术将其切除。在12个月的随访中，他没有任何症状。
肋内骨外生骨疣可引发一些并发症，如血胸、膈肌或心包损伤。对于有症状的骨外生骨疣，作者建议进行手术切除以避免严重并发症。如果骨外生骨疣无症状，可以建议不予处理。事实上，例如血胸，即使是圆形光滑的骨外生骨疣，在没有任何创伤史的情况下也可能发生。
