We report the case of a 73-year- old female patient with vomiting, aspiration pneumonia and constitutional symptoms. The imaging tests showed total gastric herniation in the pericardial sac through a pericardio-peritoneal window previously created. The case was solved with surgery. The therapeutic options for persistent pericardial effusion are considered. Intrapericardial gastric hernia as a complication, its clinical presentation, intraoperative findings, complementary tests and treatment are discussed. Rev Argent Cir. 2021;112(2):193-196. doi:10.25132/raac.v112.n2.1438.es