Refractory Ascites Possibly Contributed by Absent Pericardium

Congenital absence of the pericardium is a rare cardiac malformation, often asymptomatic, although it may present as mechanical impairment of cardiac function. We present a case of refractory ascites in a patient with congenital absence of the pericardium, where the anomaly significantly contributed to persistent abdominal fluid accumulation and symptom exacerbation.