A 12-year-old girl was followed up at the Pediatric Infectious Diseases Unit due to left chest pain associated with pneumonia.
After resolution of the pneumonic picture the chest pain persisted, so it is derived to the pediatric consultation, pediatric orthopaedic and finally to the pediatric surgery consultation.
She has a 3-month history of selective left costal pain, which is not related to postural changes or respiratory movements, is continuous and does not calm down with oral analgesics.
On physical examination, the patient complained of more severe pain on palpation of the left costal margin, locating the most painful point at the junction of the 10th left rib with the 11th.
When performing the hook maneuver, pain reproduces.
The rest of the examination revealed no pathological signs, as well as chest X-ray.
Antimicrobial treatment was recommended, ruling out other diagnostic possibilities.
As there was no improvement, excision was indicated under general anesthesia of the union of the 10th left rib with the 11th.
There were no complications in the immediate postoperative period.
In both cases, symptom resolution was observed from the first postoperative day.
After four years of evolution, the result can be classified as satisfactory.
