Jozef Wesolowski is accused of sexually abusing minors during his 2008-13 stint as Vatican ambassador to the Dominican Republic and of possessing child pornography in Rome in 2013-14.
His case is seen as a test of Pope Francis's push to prosecute sexual predators in the face of accusations that the Catholic Church has not done enough to identify and punish paedophiles in its midst.
The hospitalisation of the 66-year-old reduced the first day of his trial, which was open to the public, to seven minutes before the judge recessed until a later, unspecified date.
When the trial reconvenes, Wesolowski's lawyers may motion for it to continue in closed session.
His trial marks the first legal proceedings against a church official since Francis overhauled the Vatican justice system in response to swelling accusations of child sexual abuse by prelates.
If Wesolowski is convicted in the trial, in which the judge, defence lawyer and prosecutors are all Italian lay people, he could face a six-year prison term -- more if aggravated circumstances are found -- which he could serve in Vatican detention facilities.
He was defrocked by a Church court in June 2014 but remained free until September of that year, when he was placed under house arrest under an order the Vatican said came directly from Pope Francis.
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