Congenital peritoneo-pericardial hernia in a 4 years-old child: Case report of a rare type of congenital diaphragmatic hernia

Congenital peritoneo-pericardial Hernia (CPPDH) occurs when a defect in the central tendon of the diaphragm allows communication between the peritoneal and pericardial cavities, leading to herniation of intra-abdominal organs into the pericardial cavity. It is an extremely rare form of congenital diaphragmatic hernia with only a few reported cases in the literature. We report a case of congenital peritoneo-pericardial hernia diagnosed in a 4-year-old female child after she presented with fast breathing and intermittent cough. The diagnosis was suspected during echocardiography,when a solid mass having similar echogenicity to the liver was seen in the pericardial cavity. Computed tomography (CT) scan demonstrated a central diaphragmatic defect and herniation of the left liver lobe and the stomach into the pericardial cavity. Currently, surgery is the only option of management, and a correct diagnosis is usually not made prior to surgery. Our report highlights the crucial imaging findings helpful in the preoperative diagnosis, and also the importance of considering CPPDH as a differential diagnosis for an unusual intra-pericardial lesion discovered during echocardiography.