Congenital absence of the pericardium confirmed by spontaneous pneumothorax

This article describes a case of complete absence of the left pericardium which was diagnosed on the chest radiograph and subsequently confirmed on computed tomography and thoracoscopy. Diagnostic confidence was bolstered by the presence of pneumopericardium which communicated via the defect with a spontaneous left pneumothorax. The clinical and imaging findings of pericardial absence are reviewed.