A case of congenital intrapericardial diaphragmatic hernia in 2-month-old boy is reported He was hospitalized with respiratory disturbance. Chest radiography revealed a midline sofl tissue mass at the anterior base of the thorax. Pericardial mass and massive pericardial effusion was revealed by ultrasonography, computed tomography and pericardiocentesis. In the anterior view of the hepatic scintigram a notch was evident at the level of the diaphragm, Also he was examined by pneumoperitoneography. At surgery the intrapericardial mass was found to be the left lobe of the liver. The liver was reduced into the abdomen through a defect in the central tendinous portion of the right hemidiaphragma and the diaphragmatic Eight cases of congenital peritoneo-pericardial (i. e. intrapericardial) diaphragmatic hernia in infancy and childhood in the literature. It is unusual defect which probably occur as a result of failure of the transverse septum to close the communication between the pericardium and the peritoneal cavity. The diagnosis can be confirmed by pneumoperitoneography but the high incidence of the liver herniation allows less invasive determination by radionuclide scanning.
