Spontaneous esophageal rupture is most often preceded by a history of overeating and binge eating, followed by compulsive vomiting, which produces severe chest pain.A pressure of 0.5-1.5 Kg is usually sufficient to rupture a normal esophagus, but lower pressures may be required when disease is present. Rupture of the esophagus produces a large amount of fluid pneumothorax. The disease changes rapidly and death can occur in 12-24 hours. At 6-12h of esophageal rupture, surgical repair can be straightforward if the patient has no other disease present. If the perforation is more than 12h, the likelihood of complications of direct surgical repair is as high as 84%. Mainly septic pneumothorax and esophageal pleural fistula, local esophageal tissue repair, can be covered with surrounding tissue to prevent fistula, adequate drainage of the thoracic cavity, and gastrointestinal decompression, intravenous hypernourishment, and maintenance of water-electrolyte balance. Death rate of 39%.