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Images in neonatal medicine
Congenital absence of the left sternomastoid muscle
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  1. S Haroon1,
  2. D Beverley2
  1. 125 Magdalin Drive, Stanningley, Leeds LS28 6LD, UK
  2. 2York District Hospital, Wigginton Road, York YO31 8HE, UK; david.w.beverleyyork.nhs.uk

    http://dx.doi.org/10.1136/adc.2004.064337

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      This baby was brought to medical attention at 1 hour of age. The birth was a normal spontaneous vaginal delivery, after an uneventful pregnancy. Examination revealed an absent left sternomastoid muscle with paradoxical movement of the soft tissues in the left supraclavicular space. This was more pronounced on crying, as illustrated in figs 1 and 2. The rest of the clinical examination was unremarkable. The swelling seen superior to the clavicle was confirmed as being the herniating apex of the left lung.

      Figure 1
      Figure 1

       During expiration the pleural contents are herniating into the supraclavicular fossa. Permission to reproduce this photograph was obtained from the child’s parents.

      Figure 2
      Figure 2

       In inspiration there is paradoxical movement, with indrawing of the supraclavicular fossa. Permission to reproduce this photograph was obtained from the child’s parents.

      A literature search found only one paper1 that describes a similar infant.

      REFERENCE

      1. ↵
        Bayne SR, Lehman JA, Crow JP. Lung herniation into the neck associated with congenital absence of the sternocleidomastoid muscle. J Pediatr Surg1997;32:1754–6.
        OpenUrlCrossRefPubMedWeb of Science

      Footnotes

      • The child’s parents have consented to the publication of this article.