We have all probably experienced vomiting, and the process of vomiting is, indeed, not very pleasant. But it is probably rare for us to hear that vomiting can cause such a serious problem as esophageal rupture. In fact, violent vomiting can indeed cause esophageal rupture. A rupture of the esophagus caused by vomiting is usually about three or four centimeters. It is a rare clinical emergency in which the abdominal pressure increases suddenly when a person vomits, causing the pressure in the stomach cavity to be much higher than the pressure in the chest cavity, resulting in esophageal rupture. It is a disease with a 25-100% mortality rate, and once the rupture has occurred for more than 24 hours, the patient’s mortality rate is as high as 50%. Spontaneous esophageal rupture refers to the sudden occurrence of esophageal rupture in healthy people. Most patients (70%-80%) suffer from esophageal rupture due to vomiting after drinking alcohol, so violent vomiting is the most important cause of morbidity, and other causes include childbirth, car accidents, post-cranial surgery, epilepsy, etc. After esophageal rupture, food and gastric juice in the stomach enter the chest and abdominal cavity can cause chemical thoracic and peritonitis, so the main symptoms are vomiting, nausea, chest pain or epigastric pain. Normally, the thoracic and abdominal cavities of the human body are ‘two different homes’ with a ‘ceiling’ between them, clinically called the ‘diaphragm’, and the esophagus, via the neck and thorax. The thoracic segment is connected to the internal abdomen of the gastric cavity through the diaphragmatic foramen. Once the esophagus ruptures, it is not only easy to cause inflammation of the thoracic tissue outside the esophagus and allow fluid to enter the thoracic cavity, i.e., pleural effusion. What is more frightening is that once the gastric contents objects, especially gastric acid (which has a PH value of only 3 and is very corrosive), run into the thoracic cavity, then there is the risk of fatalities. The treatment and outcome of spontaneous esophageal rupture are closely related to the early diagnosis, the size of the rupture, the amount of gastric contents entering the chest cavity, and the degree of contamination. The earlier it is detected, the better the outcome of treatment. The chances of the esophageal rupture healing on its own are very small, and surgical treatment is mostly required. After spontaneous esophageal rupture for more than 24 hours, it is not suitable for surgery. It can be treated conservatively by strengthening nutrition and nasal feeding of not less than 1500~2000 calories per day. Also cough and other methods to swell the lungs well. Clear drainage. Control the infection. As for the time to return to normal, it is impossible to determine, depending on the situation of the ruptured esophagus and whether the treatment measures are timely and appropriate, usually it takes one or two months of conditioning time.