A case of spontaneous rupture of the esophagus was successfully treated by a T-tube drainage method with chest drainage, gastrostomy, feeding jejunostomy and intravenous high caloric feeding. Our suggested treatments for spontaneous perforation of the esophagus are as follows: (1) Primary direct closure of the tear may be performed in an early case. It is important to place a feeding jejunostomy. (2) Fundic patch method may be useful in a delayed case in which the time for primary direct closure of the tear is considered too late. (3) In a more delayed case such as ours, adquate drainage, including a T-tube, should be instituted.