Abstract
Boerhaave syndrome is a rare but potentially life-threatening condition. Although various optimized treatment methods have contributed to an improvement in the cure rate. However, cases with chronic esophageal pleural fistula and empyema resulting from delayed diagnosis or inadequate treatment occasionally occur. Chronic esophageal pleural fistula and empyema lead to long-term consumption and significant decline in quality of life for patients. We present a case of chronic esophageal-pleural fistula complicated by empyema formation following Boerhaave syndrome, which remained unresolved over a two-year period. A favorable clinical outcome was achieved after the performance of modified thoracoplasty.