{Reference Type}: Case Reports {Title}: Gastropericardial fistula induced acute purulent pericarditis. {Author}: Ni B;Chen YL;Lin PC;Hou YT;Ho YT;Wu MY; {Journal}: Am J Emerg Med {Volume}: 46 {Issue}: 0 {Year}: 08 2021 {Factor}: 4.093 {DOI}: 10.1016/j.ajem.2021.02.006 {Abstract}: Gastropericardial fistula is a rare but lethal condition. Several etiologies have been reported, including previous gastric or esophageal surgery, malignancy, trauma, infection, and ulcer perforation. Typical symptoms included chest pain, epigastric pain, fever and dyspnea. Gastropericardial fistula can lead to serious complications, including cardiac tamponade, sepsis, hemodynamic compromise and death. Therefore, early diagnosis and timely management are important for physicians to prevent from catastrophic complications. Here, we present a case of a man who presented with acute purulent pericarditis secondary to a gastropericardial fistula to highlight the pathogenesis and suggest therapeutic strategies.