[Diagnosis of congenital pleuropericardial defects]

Pleuro-pericardial defects have been found incidentally during post mortems or chest surgery but, because of their usual lack of symptoms, are rarely found otherwise. If suspicion of such a malformation arises, it should be clarified because of possible herniation of the atrium or ventricle. The necessary diagnostic steps are discussed in relation to two patients and the value of chest x-rays is stressed. A pleuro-pericardial defect should be diagnosed because of the typical radiological changes of the cardiac contour. Only in exceptional cases should it be necessary to induce a diagnostic pneumothorax or to perform an exploratory thoracotomy.