“…Some reports state that, after 24 h of the rupture, the esophageal wall in the region of the lesion is too inflamed and fragile for primary closure, and only careful pleural drainage should be done [1,6,19]. Like some other authors, we have treated with success esophageal ruptures by primary-suture closure also more than 24 h after the rupture [12,[20][21][22], However, the mortality rises significantly when the treat ment has delayed more than 48 h. The treat ment results of our series demonstrate clearly that the most important factors for reducing mortality and morbidity are early diagnosis and immediate primary-suture closure of the esophageal rupture.…”