Abstract
INTRODUCTION: Bifid ribs are a type of, generally asymptomatic, congenital chest wall abnormality. However, patients sometimes complain about chronic chest pains, deformities and respiratory difficulty. There is limited literature regarding treatment of symptomatic bifid ribs. We present the results of two cases of symptomatic bifid ribs causing intercostal nerve impingement who underwent surgery. PRESENTATION OF CASE: Two patients aged 22 and 33 presented to the outpatient clinic with chronic chest pains. After physical examination and 3D CT-scans they were diagnosed with intercostal nerve impingement caused by a bifid rib. Both patients underwent surgery to resect the upper arch of the bifid rib. Upon follow-up nine and seven months post-operatively patients reported complaints had been completely resolved and follow-up was ended. DISCUSSION: Although bifid ribs are generally asymptomatic they can sometimes cause intercostal nerve impingement. These cases demonstrate that these symptoms might only start after experiencing minor trauma or a growth spurt. Intercostal nerve blockades might me a useful tool in diagnostic work-up to confirm the diagnosis. CONCLUSION: Resection of symptomatic bifid ribs is a safe and viable treatment option.