Surgical treatment of esophageal perforation remains controversial and depends on operator discretion. Multidisciplinary management is expected, especially in critically ill patients with an uncontrolled condition. Surgeons seek advice on esophageal tears. According to some authors, surgical treatment is indicated only for defects larger than 1.5 cm[1]. Treatment includes thoracic and mediastinal revision, esophageal reconstruction, mucosal neutralization, nasogastric tube with food restriction, parenteral nutrition, broad-spectrum antibiotics, and corticosteroids[1]. Corticosteroids are administered for 4 to 8 weeks to reduce inflammation and prevent strictures[1]. Endoscopic treatment with clips makes it possible to close the perforation without surgery[3]. Definitive treatment of perforation usually requires surgical intervention after stabilization of the patient[5].