Esophageal rupture may occur from an external force such as an explosion or trauma to the chest, spontaneouslyas from vomiting, by instrumental peforations during endoscopy, or by foreign bodies. A case of Boerhaave syndromewas seen in a healthy 52 years old man who complained of substernal pain, vomiting and dyspnea afterover-drinking. Abnormalities seen on the chest film were : A) hydropneumothorax B) mediastinal emphysema and C)subcutaneous emphysema. These characteristic roentgen findings were confirmed an esophageal rupture.