Abstract
Spontaneous esophageal perforation is a well-recognized, life-threatening emergency. The spectrum of presentation is a major reason for errors in diagnosis and the failure to institute prompt and imminent management. A case of Boerhaave's syndrome, diagnosed and managed non-operatively in a tertiary center three days after tear, is described. The diagnosis was confirmed with a series of gastrograffin esophagograms which revealed a leak in the lower part of the esophagus, with hydropneumothorax.