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The majority of patients with acute chest pain are non-life-threatening etiologies. Nevertheless, catastrophic cause of chest pain such as acute coronary syndrome, aortic dissection, pulmonary embolism, esophageal perforation, and pericarditis must be considered in the differential diagnosis. Perforations at the mid or distal esophagus lead to collections in the respective pleural cavities, resulting in serious complications such as mediastinitis, abscess, empyema, pericarditis or cardiac tamponade. Esophageal perforation rarely occurs secondary to foreign body ingestion. Pericarditis due to the esophageal rupture secondary to the foreign bodies are extremely rare, and were reported in the literature in a few number. In this case report, we presented a pericarditis case due to esophageal rupture caused by ingestion of a foreign body. Fifty-nine year-old-patient applied to the emergency service with chest pain. The pain was in stinging character and spreads to the back. Arterial blood pressure, heart rate and temperature were 100/60 mmHg, 100 beat per minute, 38,8oC respectively on physical examination. Electrocardiography was shown ST segment elevations in all derivations except V1 and aVR (Figure 1). Transthoracic echocardiography demonstrated pericardial effusion. The patient was hospitalized to the coronary care unit with pre-diagnosis of pericarditis. As a treatment ibuprofen 850 mg p.o. and proton pump inhibitor were initiated. There was no clinical change in the patient despite 12 hours treatment, so we decided to investigate any rare cause of pericarditis. After a carefull questioning, we learned that the patient ingested chicken bone while he was eating chicken 2 days ago. Thoracal CT imaging was taken with the suspect of esophageal rupture. Mid-esophageal perforation, esophageal-wall thickening, periesophageal mediastinal air, intraesophageal foreign body and a left pleural effusion were found on thoracal CT (Figure 2). Patient was stabile and thoracic surgeons recommended the primary repair. ECG signs resolved and the patient was stable during follow up after the surgery (Figure 3). Esophageal perforation is a serious disorder that is difficult to diagnose and manage. Optimal therapy includes primary repair of the perforation site and elimination of distal obstruction. It is noteworthy to keep in mind that even all the symptoms indicate pericarditis, it can be a complication of underlying disease.