A case of strangulated intrapericardial herniation of the small bowel following pericardial-peritoneal window

We report a rare case of strangulated intrapericardial herniation of the small bowel following establishment of a pericardial-peritoneal window. A 96-year-old woman, in whom a pericardial-peritoneal window was established 5 months before for persistent pericardial effusion, developed sudden intense abdominal pain and was admitted to the hospital. Abdominal computed tomography revealed a segment of the small bowel in the pericardium. As strangulated intrapericardial hernia of the small bowel was suspected, emergent laparotomy was performed. A 30cm segment of the small bowel was strangulated by the pericardial window, and was necrotic. Partial resection of the small bowel was performed and the window was covered by the round ligament of liver and closed. The postoperative course was good and the patient was discharged on the 24th postoperative day.