We report a case of spontaneous rupture of the esophagus accompanied by extensive bowel necrosis caused by nonocclusive mesenteric ischemia. The patient was treated successfully with prompt surgical intervention after an early diagnosis. A 61-year-old man was admitted to our hospital complaining of abdominal pain after drinking. On arrival, he was suffering shock. Thoracoabdominal computed tomography and esophagoscopy findings were highly suggestive of rupture of the esophagus above the esophagogastric junction and extensive bowel necrosis. Emergency laparotomy revealed extensive bowel necrosis from the jejunum to the transverse colon; thus, we resected the entire affected region and performed jejunostomy and transverse colostomy. After suturing the esophageal perforation directly, we performed intramediastinal packing of the omentum and inserted drains. The patient recovered well and was discharged from hospital on postoperative day 126. To the best of our knowledge, this is the first case report of spontaneous rupture of the esophagus with nonocclusive mesenteric ischemia.
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