Intercostal retractions occur when the muscles between the ribs pull inward. The movement is most often a sign that the person has a breathing problem.
Intercostal retractions are a medical emergency.
Retractions of the chest muscles
The wall of your chest is flexible. This helps you breathe normally. Stiff tissue called cartilage attaches your ribs to the breast bone (sternum).
The intercostal muscles are the muscles between the ribs. During breathing, these muscles normally tighten and pull the rib cage up. Your chest expands and the lungs fill with air.
Intercostal retractions are due to reduced air pressure inside your chest. This can happen if the upper airway (trachea) or small airways of the lungs (bronchioles) become partially blocked. As a result, the intercostal muscles are sucked inward, between the ribs, when you breathe. This is a sign of a blocked airway. Any health problem that causes a blockage in the airway will cause intercostal retractions.
Intercostal retractions may be caused by:
Seek medical help right away if intercostal retractions occur. This can be a sign of a blocked airway, which can quickly become life threatening.
In an emergency, the health care team will first take steps to help you breathe. You may receive oxygen, medicines to reduce swelling, and other treatments.
When you can breathe better, the health care provider will examine you and ask about your medical history and symptoms, such as:
Tests that may be done include:
Roosevelt GE. Acute inflammatory upper airway obstruction (croup, epiglottitis, laryngitis, and bacterial tracheitis). In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 385.
Sarnaik AP, Clark JA, Sarnaik AA. Respiratory distress and failure. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 71.