Intercostal retractions

Considerations:
The chest wall is flexible, which allows for normal breathing. Cartilage that attaches the ribs to the sternum allows free movement of bony structures so that the rib cage can expand and contract. During breathing, the muscles between the ribs (intercostal muscles) contract and pull the rib cage upward while the diaphragm moves downward, thus increasing the volume of the chest cavity and causing air to be drawn into the lungs.

When the trachea (upper airway) becomes partially blocked so that air flow is restricted, the normal increase in chest cavity size reduces the pressure within the chest and the intercostal muscles are drawn inward, between the ribs. This inward retraction is a sign of airway obstruction . Diseases or conditions that cause restriction of the airway will cause intercostal retraction.

Common Causes:

Note: There may be other causes of intercostal retractions. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for intercostal retractions, occurring alone or in combination with other problems.

Home Care:
Consult your health care provider.

Call Your Healthcare Provider If:

  • intercostal retractions occur. This can be a sign of airway obstruction , which can quickly become life threatening.
  • other symptoms are also present. If the skin, lips, or nailbeds are blue, or if the person becomes confused , drowsy , or hard to awaken, this is an emergency situation!



What to Expect:
In emergency situations, interventions will be taken first to help with the breathing. This may include oxygen, medications to reduce swelling , or other measures.

When the condition is stable enough to allow it, the history will be obtained and a physical examination performed to determine the cause of the airway obstruction .

Medical history questions documenting intercostal retractions in detail may include:

  • time pattern
    • When did it start?
    • Is it getting better, worse, or staying the same?
    • Does it occur all the time?

  • quality
    • How bad is it?

  • history
    • Did you notice anything significant that might have caused an airway obstruction?
    • Have you or the child been ill, coughing , or complaining of a sore throat ?
    • Have you seen the child putting anything in the mouth that might have been inhaled into the airway?
    • What other symptoms are also present? Especially, did the child turn blue, wheeze , or have a high-pitched sound when breathing ( stridor )?

Diagnostic tests may include:

After seeing your health care provider:
You may want to add a diagnosis related to intercostal retractions to your personal medical record.