Abstract: ObjectiveIn order to improve the diagnosis and treatment of constrictive pericarditis (CP) in children by analyzing the etiology, misdiagnostic causes,clinical manifestations, diagnosis,treatment and prognosis of the disease.Methods From January 1996 to January 2018, 78 patients with confirmed CP were enrolled. Data on clinical characteristics, disease manifestations, treatment, and outcomes were collected and analyzed.Results Seventy-eight patients with CP were enrolled. There were 49 males with an average age of 9.4 (1 to 15.4) years and an average duration of 13.4 months (6 days to 7 years). There were 6 cases (7.7%) with history of tuberculosis before the disease, and there were 41 cases (52.6%) with no clear history of acute pericarditis. The first symptom was edema (61/78, 78.2%), and the most common sign was hepatomegaly (72/78, 92.3%). The etiology was unclear in 30 cases (38.4%). The main cause was paragonimiasis infection (19 cases, 24.4%) in patients with clear etiology. Twenty cases (25.6%) were misdiagnosed as other diseases. The positive rate of chest radiography was 70.5%(55/78); chest perspective was 92.3%(45/48); cardiac CT was 100% (31 /31); cardiac MRI was 100%(1/1), and echocardiography was 92.3%(72 /78). Sixty-one patients (78.2%) underwent surgery and were found that the pericardium was uneven. Pathological biopsy was performed in 60/61 surgical patients, with pericardial thickening in 59 cases (98.3%) and normalpericardial thickness in 1 case (1.7%). Pathological examination showed there were 48 cases of non-specific CP (80.0%), 6 cases of tuberculous pericarditis (10.0%), 4 cases of suppurative pericarditis (6.7%), and 2 cases of paragonimal pericarditis (3.3%). Of the 61 surgical patients, 60 were discharged and one died. Seventeen patients gave up surgery, 7 of whom lost contact, and 10 were dead.Conclusion Most of CP were of unknown cause, but in known causes paragonimiasis had a high incidence. The misdiagnosis rate of pediatric CP was high. Docters' better understanding of CP may reduce misdiagnosis. Pathological biopsy had low specificity in determining etiology. Echocardiography was still the first choice for the diagnosis of CP. Pericardial stripping is considered the best surgical procedure in the treatment of CP, and the prognosis is good.

Key words: Children, Constrictive pericarditis, Etiology, Misdiagnosis, Prognosis, Treatment