Congenital pericardio-peritoneal communication with herniation of omentum into the pericardium. A rare cause of cardiomegaly.

Abstract

A patient with a congenital defect of the pericardium with herniation of the greater omentum within the pericardial cavity is described; the condition was recognized during life. The value of echocardiography as a diagnostic tool is emphasized. Successful surgical treatment was carried out.

Intrapericardial diaphragmatic hernia in adults

“…Thus, the congenital etiology of IDH in adults must be accepted; the lack of a history of trauma should not rule out IDH. 20 Regardless of the cause of the defect, peritardial diaphragmatic rupture allows free transmission of the negative pleural pressure to the peritoneum. The resulting gradient, though only 7-20 cm of water at rest, increases greatly during vigorous respiratory effort and encourages herniation.2'39 Although small tears may heal, larger tears are usually filled initially with omentum, which prevents healing and initiates stretching of the defect and the pericardial sac.…”