A previously healthy 11-year-old girl was referred for pediatric cardiology evaluation because of the development of progressive bilateral lower extremity swelling over the course of 2 years. Her prior workup had included a negative result for proteinuria and a negative ultrasound for deep venous thrombosis. On physical examination, in addition to her edema, she was found to have a severe pectus excavatum deformity, which prompted cardiac magnetic resonance imaging. This study demonstrated compression of the inferior vena cava. She underwent uneventful pectus repair with use of a modified Ravitch procedure and experienced complete resolution of her lower extremity edema.
Iannucci, G. J., Slesnick, T. C., Kogon, B., & Samai, C. (2015). Lower extremity edema in a child due to pectus excavatum. Annals of Thoracic Surgery, 99(2), e29–e30. https://doi.org/10.1016/j.athoracsur.2014.11.051