Use of a flexible choledochoscope for pericardioscopy and drainage of a loculated pericardial effusion.

In recurrent or persistent pericardial effusion a subxiphoid pericardial window may be used to drain fluid from the pericardial cavity.' 3 A more permanent form of drainage may be achieved if a combined peritoneal pericardial window is used.4 We describe a case in which we could not initially reach the pericardial effusion through a pericardial window because it was loculated posteriorly. Subsequently a flexible choledochoscope was used successfully to locate and drain the effusion. Inspection ofthe heart and the pericardium was performed at the same time.