An unusual cause of recurrent chest pain

Abstract

BY FAR the most common cause of pleural effusion in children is pulmonary infection. When infection is excluded as a cause of pleural effusion in a child, an uncommon or even rare cause must be sought. The case reported here was characterized by recurrent episodes of chest pain and pleural effusion. Bacterial infection was not present, and only after extensive studies did it become evident that the pleural effusion was caused by spontaneous drainage of pericardial effusion into the left pleural cavity through a congenital defect in the pericardium. Report of a Case A 12-year-old boy was transferred to Children's Medical Center with a four-day history of chest pain and orthopnea. He had not had any recent respiratory infection, fever, or chest trauma. Symptoms similar to current ones had occurred both 36 and 14 months earlier. During the latter illness, the boy had been hospitalized because of massive left pleural