Alcohol consumption can cause spontaneous rupture of the esophagus, the cause and mechanism of which are not fully understood. Most patients have vomiting followed by esophageal perforation, so vomiting is the most important cause. Since the esophagus lacks a plasma membrane, it is more prone to rupture at lower pressures than other organs of the digestive tract. During vomiting, the diameter of the lower esophagus can instantly expand five times or more than usual. In addition, the negative pressure in the thoracic cavity increases the pressure difference between the inside and outside of the esophageal wall, and during violent vomiting, the esophageal pressure rises sharply, the cardia opens, and a large amount of gastric contents rushes into the esophagus, and at the same time, the pharyngeal muscle spasms, so that the high-pressure state of the esophagus can not be relieved, thus resulting in rupture of the esophagus. Spontaneous esophageal rupture mainly occurs after vomiting caused by various reasons, so some scholars believe that it is more accurate to call this disease vomiting esophageal rupture. It is significantly more common in males than in females, and most patients are young adults, but it can also occur in people over 50 years of age. It is easy to see that alcoholism is the culprit of esophageal rupture. Spontaneous esophageal rupture after alcohol consumption has the following characteristics: 1. The initial symptoms are vomiting, nausea, epigastric pain and chest pain. Some patients have vomited blood. Patients can often have a history of alcohol consumption or overeating. The location of the pain is mostly in the epigastric region, but it can also be in the posterior sternum, the quarter ribs, the lower chest, and sometimes radiates to the back of the shoulder. When the symptoms are severe, there may be shortness of breath, dyspnea, cyanosis, shock and other manifestations. 2, the physical examination of the performance of the acute abdominal symptoms, there can be liquid pneumothorax corresponding signs, epigastric pressure, muscle tension, and even the abdomen is plate-like. Esophageal and gastric contents enter the thoracic and peritoneal cavity, which can cause chemical pleurisy and peritonitis. Therefore, patients can have acute purulent mediastinitis and thoracic and peritonitis manifestations. 3.Esophageal rupture patients can have no fever in the early stage, and the blood leukocytes are not elevated. Later, there may be fever, chills, increased blood leukocytes, and even septicemia. Due to the many variations in the clinical manifestations of this disease, it often leads to misdiagnosis and misdiagnosis, and is most likely to be misdiagnosed as “acute upper gastrointestinal perforation”. Therefore, after overeating, frequent vomiting or vomiting bloody gastric contents, chest pain, dyspnea or shock, should be alert to the possibility of esophageal rupture.