A 5-day-old boy, born at term (Birth weight 2.52 kg), presented to our institution with a congenital defect in the anterior chest wall (Fig. 1). On examination, there was no sternum and the contracting heart with great vessels was visible underneath a thin layer of skin (Web Video 1). A diagnosis of complete sternal cleft was confirmed by digital X-rays and computed tomography. No other abnormality was detected.

 

Fig. 1 Congenital absence of sternum in a newborn.

Asternia (absence of sternum) is rare, and may be associated with Cantrell’s pentalogy and Leiber’s syndrome. Mother should take adequate precaution while handling such infant during feeding and routine care as there is chance of injuring the heart. The treating physician should also be careful before putting the stethoscope or echocardiography probe over the pulsating heart to avoid external trauma. Surgical repair is the treatment of choice.