Conclusion
Our patient with no history of esophageal disease, presented with partial thickness esophageal perforation from the hypopharynx to the aortic arch. Due to the unusual location of a spontaneous esophageal perforation, her mild symptoms, and her imaging, she was felt to have a retropharyngeal abscess. Our case is the first study showing a hypopharyngeal and cervical esophageal perforation following yelling. She underwent combined open and endoscopic repair and is back to baseline 5 months after intervention.