Key result
Pericardiectomy reverses advanced liver fibrosis at 3 months in a child with constrictive pericarditis.
Why the study?
Chronic constrictive pericarditis is a rare cause of pediatric heart failure that can present with nonspecific symptoms and cause chronic venous congestion resulting in liver injury mimicking cirrhosis.
Does pericardiectomy reverse advanced liver fibrosis in a pediatric patient with chronic constrictive pericarditis?
Case Report (n=1)
Does pericardiectomy reverse advanced liver fibrosis in a pediatric patient with chronic constrictive pericarditis?
Advanced liver fibrosis secondary to venous congestion in pediatric constrictive pericarditis is reversible after pericardiectomy.
May indicate reversibility of cardiac hepatopathy after pericardiectomy; hypothesis-generating and requires confirmation in larger cohorts.
BACKGROUND: Chronic constrictive pericarditis is a rare cause of heart failure in children and may present with nonspecific symptoms. Chronic venous congestion can result in liver injury mimicking cirrhosis. CASE SUMMARY: An 8-year-old boy presented with exercise intolerance, dyspnea, and longstanding gastrointestinal symptoms leading to a diagnostic delay of nearly 5 years. Evaluation revealed hepatomegaly and advanced liver fibrosis (METAVIR F4) on elastography, despite preserved liver function. Multimodality cardiac imaging demonstrated features consistent with constrictive pericarditis. The patient underwent successful pericardiectomy. At 3-month follow-up, liver stiffness regressed to METAVIR F1, indicating reversal of congestion-related fibrosis. DISCUSSION: Diagnosis of pediatric constrictive pericarditis remains challenging. This case demonstrates that advanced fibrosis due to venous congestion may be reversible after correction of the underlying hemodynamic abnormality. TAKE-HOME MESSAGES: Constrictive pericarditis should be considered in children with systemic venous congestion. Timely surgical treatment may lead to reversal of liver fibrosis.
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Konchina et al. (2026) conducted a case report in Pediatric Constrictive Pericarditis (n=1). Pericardiectomy was evaluated on Liver stiffness/fibrosis regression. Pericardiectomy in an 8-year-old boy with constrictive pericarditis led to the regression of advanced liver fibrosis from METAVIR F4 to F1 at 3-month follow-up.
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