先天性肋骨缺失與腰肋：一位病患之兩种肋骨畸形：一病例報告

Congenital Rib Absence and Lumbar Ribs: Two Rib Abnormalities in One Patient: A Case Report

先天性肋骨缺如不是一種很常見的畸形。在胎兒、新生兒、嬰兒和幼兒中都有描述，但在成人中非常罕見。一名42歲男性病患者因胸部鈍器外傷而就診於我院門診。他主訴左胸外傷處胸痛。胸部電腦斷層掃描顯示胸部飽滿，但第一肋前部缺失，左側第6~ 9肋骨折。胸部電腦斷層掃描三維重建顯示左側第6–9肋骨骨折，第1肋前部缺失，胸骨柄向右下方傾斜，一對腰肋。建議他休息並定期隨訪。肋骨缺失的無症狀患者通常不需要治療。外科治療僅適用於有嚴重症狀或嚴重胸廓變形的患者。腰椎肋骨的病患通常沒有重要的臨床意義。腰椎肋骨的早期診斷是必要的，以避免其對手術定位的誤導。

Congenital rib absence is an uncommon anatomic anomaly. This lesion has been reported in fetuses, newborns, infants and small children, but it is very rare in adults. A 42-year-old male patient presented to our clinic due to blunt chest trauma. He complained of chest pain on the left chest due to trauma. Chest computed tomography revealed the fullness of the chest, but the anterior part of the first rib was missing, and left sixth to ninth rib fractures were noted. The three-dimensional reconstruction of the computed tomography showed left sixth to ninth rib fractures, absence of the anterior part of the first rib, the manubrium sterni tilted to the lower right, and a pair of lumbar ribs. He was advised to rest and have regular follow-up. Asymptomatic patients with missing ribs usually do not require management. Surgical treatments are only indicated for patients with missing ribs with severe symptoms or a severely deformed rib cage. Lumbar ribs are usually also asymptomatic and do not have any important clinical significance. An early diagnosis of lumbar ribs is necessary for avoiding misguidance in the surgical locations. This is the first case report of a congenital rib absence combined with lumbar ribs.