Presentation
Epigastric discomfort
Patient Data
Age: 20 years
Gender: Male
From the case:
Pericardial effusion
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Frontal

The cardiac silhouette is enlarged.
There is minimal left pleural effusion.
From the case:
Pericardial effusion
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Axial non-contrast

There is dense pericardial fluid. The pericardium is thickened.
Minimal left pleural effusion is demonstrated.
From the case:
Pericardial effusion
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Lateral x-ray

Pericardial fluid (yellow *) sandwiched by the radiolucent paracardial fat (blue arrows) and epicardial fat (red arrows) resulting to the Oreo cookie sign.
Case Discussion
This is a case of pericardial effusion in a patient suspected of pericarditis.