The esophageal perforation Is the most rapidly fatal and most serious perforation of the gastrointestinal tract. The 53 year old male patient was admitted because of substernal and epigastric pain altar esophageal bougienage for the indigestion and the difficult swallowing before about 18 hours. On esophagogram, there was the extravasation of contrast media at the right side of the lower esophagus [retrocardiac segment]. The emergency thoractotomy, debridement and suture closure with drainage were performed. But after 7 days the esophageal leakage was complicated again with pus discharge, although primary repair was done. On the 13th hospital day, the temporary cervical esophageal fistulation with dual drainages was made under general anesthesia. On the 38th day after this procedure, the esophageal leakage was closed spontaneously. On the 63rd hospital day the cervical fistulation was repaired and ever since the esophageal passage was good without leakage or swallowing difficulty.[KTCS 1981;1:77-82]