Spontaneous rupture of the esophagus in the newborn has been infrequently reported. Review of the literature fails to reveal a report of esophageal perforation in the newborn due to trauma. Such a case is reported here. A 28-hour-old female infant weighing 6 pounds, 1 ounce was admitted in respiratory distress to the U.S. Naval Hospital, Philadelphia, from another activity on Oct. 17, 1959. Respirations were reported delayed at birth. The infant was aspirated with machine suction and received 1 cc. of caffeine sodiobenzoate, fairly normal respirations being established in 4 minutes. It was later ascertained that a stiff rubber catheter had been used for the aspiration. On admission to this hospital, the child continued to exhibit respiratory embarrassment with sternal retraction, despite continuous administration of oxygen. Breath sounds were markedly diminished on the right, and x-rays demonstrated a right tension pneumothorax (Fig. 1). Thoracentesis was immediately performed, and with continuous