A 72-year-old woman with liver cirrhosis developed spontaneous esophageal rupture due to vomiting after meals. The middle thoracic esophagus was perforated, and was, therefore, clipped endoscopically. The patient was found to have mediastinal emphysema on the chest CT image, we diagnosed as Boerhaave syndrome. The esophagus was perforated atypically. The patient was discharged in stable condition by conservative therapy. Endoscopic injection sclerotherapy may have effect that patient has not developed serious condition.

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