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. (2021). Revista Argentina de Cirugía, 112(2), 193-196. https://doi.org/10.25132/raac.v112.n2.1438.es (Original work published 2021)