Penumopericardium due to transdiaphragmatic perforation of a gastric ulcer.

A 65-year-old man presented with cardiogenic shock and massive pneumopericardium. A gastropericardial fistula due to transdiaphragmatic penetration of a large fundal ulcer was documented radiographically and confirmed at autopsy. Previously recorded cases of penumopericardium complicating gastric ulcers or other diseases of the digestive tract are briefly reviewed.