A 77-year-old man vomited after alcohol drinking and was sent to our hospital by an ambulance due to sustained chest pain. Chest computed tomography (CT) showed pneumothorax and pleural effusion, and thoracic drainage was performed. Since food residue was found from chest drainage and esophagoscopy and esophagography showed injured potion on the left wall of the lower thoracic esophagus perforating to the left thoracic cavity, a spontaneous esophageal rupture was diagnosed. Establishment of fenestration for open drainage and gastrostomy were performed. After 49 days, the fistula was successfully closed by cleaning of the left thoracic cavity, with application of basic fibroblast growth factor and enteral nutrition through gastrostomy. The fenestration was closed after 53 days and the patient was discharged after 78 days.
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