Xiphoid process syndrome

A 61-year-old man who engaged in the construction industry presented to the hospital with a 5-year history of intermittent xiphoid process pain accompanied by nausea and vomiting. The pain was obvious when the patient bent over, or upon epigastric fullness. On physical examination, a hard protuberance was palpated in the epigastrium. Computed tomography of the chest showed an elongated and upturned xiphoid process (Fig. A). The measured length of the xiphoid process was 76.8 mm (reference range, 40–50 mm). The angle from the sternal body to xiphoid process was 150° (reference range, 160–180°). The patient underwent resection of the xiphoid process and had resolution of symptoms.