A case of Boerhaave's syndrome managed without thoracotomy is describe
d. The diagnosis was not confirmed for 24 h when a barium swallow reve
aled free rupture of the esophagus into the left pleural cavity. Altho
ugh survival has been reported with nonoperative management of contain
ed esophageal perforations, to our knowledge, this is the first report
of surviving Boerhaave's syndrome with free pleural rupture, without
thoracotomy.