Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Oct;29(8):779-783.
doi: 10.1177/02184923211019179. Epub 2021 May 20.

Operative results after xiphoidectomy in patients with xiphodynia

Frank P Garssen  1 , Margot B Aalders  1 , Marcel J van der Poel  1 , Wietse P Zuidema  2
Affiliations
Case Reports

Operative results after xiphoidectomy in patients with xiphodynia

Frank P Garssen et al. Asian Cardiovasc Thorac Ann. 2021 Oct.

Abstract

Background: Xiphodynia, the painful xiphoid process, is a rare condition with an atypical presentation. Symptoms differ in severity and site, and can consist of chest, throat, and upper abdominal pain. Primarily, other more severe causes of these symptoms need to be excluded. After this exclusion as xiphodynia is diagnosed, treatment can consist of a multitude of options, since there is no consensus regarding the optimal treatment. The aim of this study was to describe the outcomes and efficacy of one of the options, namely surgical resection of the xiphoid in patients with xiphodynia.

Methods: In this retrospective case series, all consecutive patients that underwent xiphoidectomy for xiphodynia between January 2014 and December 2017 were included. Patients' medical files including pre-operative work up, NRS scores, surgical outcomes, and follow up were reviewed. All patients received a questionnaire with follow-up questions.

Results: A total of 19 patients were included. None of the patients had surgery-related complications. Response rate of the questionnaire was 84% and showed that 94% of patients had an improvement of complaints after surgery, with 10 patients (63%) being totally pain free, after a mean follow-up from 34 months after surgery.

Conclusions: Xiphoidectomy is feasible and safe for the treatment of patients with xiphodynia with an improvement of complaints in nearly all patients.

Keywords: Xiphodynia; chest; sternal; surgical outcome; thoracic surgery; xiphoidectomy.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
CT image (sagittal plane) showing the xiphoid process bending forwards and sticking out in the soft tissues.
Figure 2.
Figure 2.
Operative image of the curved xiphoid process after being released from surrounding tissue, before removal.
See this image and copyright information in PMC

References

    1. Hogerzeil DP, Hartholt KA, de Vries MR. Xiphoidectomy: a surgical intervention for an under documented disorder. Case Rep Surg 2016. Published online 9 November 2016. DOI: 10.1155/2016/9306262 - PMC - PubMed
    1. Lipkin M, Fulton LA, Wolfson EA. The syndrome of the hypersensitive xiphoid. N Engl J Med 1955; 253: 591–597. - PubMed
    1. Dom P, Kuhn MA, Schweizer BA, et al.. Xiphoidectomy for intractable xiphodynia. World J Surg 2018; 42: 3646–3650. - PubMed
    1. Yapici Ugurlar O, Ugurlar M, Ozel A, et al.. Xiphoid syndrome: an uncommon occupational disorder. Occup Med 2014; 64: 64–66. - PubMed
    1. Simpson JK, Hawken E. Xiphodynia: a diagnostic conundrum. Chiropr Osteopat 2007; 15: 13. - PMC - PubMed

Publication types