Unsuspected esophageal perforation in association with chronic peptic stricture

A case of vomiting-induced perforation of the lower esophagus proximal to a chronic peptic stricture is described. The patient had a remarkably benign course and conservative management resulted in complete cure. Criteria for nonoperative management of esophageal perforation are outlined. Esophageal injury due to retained pills, we believe, contributed to occurrence of this syndrome.