ABSTRACT Spontaneous rupture of the esophagus remains a medical and surgical challenge, Both of these, gastroesophageal reflux and infection interfere with healing of esophageal perforations and prolong the associated complication of esophagitis, mediastinitis, empyema and persistent fistula. A patient with Boerhaave syndrome was successfully treated by ballon tip esophagogastric tube, Prevention of gastroesophageal reflux, continuous irrigation of perforated area by antiseptic solution, and nutritional support were ensured with this method