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Liver Cirrhosis Cured by Pericardiectomy–A Rare Case of Constrictive, Non-Calcifying Pericarditis

Katharina Meszaros, Doris Wagner, Helmut Müller, Florian Iberer, Albrecht Schmidt, Rainer R Rienmüller, Rudolf Stauber, Peter Kornprat and Heinrich Mächler

Constrictive pericarditis usually leads to heart failure but can also cause extra cardiacdiseases. We report a patient who presented with dyspnea, recurrent pericardial and pleural effusions as well as ascites. An initial cardiologic examination revealed a pericardial effusion without severe hemodynamic impairment, but without signs of additional pathologies. Abdominal sonography showed liver cirrhosis, which was laboratory classified as Child grade B. The patient was referred to a transplantation center for liver transplant evaluation. During the liver transplant evaluation process, Cardiac Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) finally revealed a constrictive non-calcifying pericarditis as the origin of the cardiac cirrhosis and the patient was scheduled for periand partial epicardiectomy.

Two years later, clinical and biochemical liver parameters were completely restored. There was no recurrence of ascites or pleural effusions. At follow-up, cardiac CT and MRI proved the absence of a pericardial constriction while liver sonography showed normal hepatic morphology.

This case presents a highly rare cause for liver cirrhosis and underlines the importance of a complete cardiac evaluation in case of a present liver cirrhosis of unknown causes.