Two cases of congenital complete absence of the left pericardium are presented. One, in a youth aged 17 years, had an associated patent ductus arteriosus; the other occurred in a woman aged 65 years with carcinoma of the lower third of the oesophagus. In both, the pericardial lesion was discovered as an incidental finding—at thoracotomy. The anatomical and radiographic features are described. Complete absence of the left side of the pericardium needs no surgical treatment and is compatible with normal life expectancy. On the other hand, because of the dangers of herniation of the heart with strangulation, partial defects should be closed, using either mediastinal pleura or fabric such as Dacron or Teflon.
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