The authors describe a case of a71-year-old man with atypical presentation of this syndrome in the lower abdominal part of esophagus without typical clinical signs. The patient was admitted for protracted heavy vomiting and suspicion of volvulus of the stomach.
The perforation was diagnosed endoscopically. The treatment was complicated by post operation dehiscence of sutures that was successfully managed by perioperation drainage, followed by parenteral and later enteral nutrition by nasojejunal probe.