True statement about Boerhaave's Syndrome is

Occurs classically when a person vomits against a closed glottis. The pressure in the oesophagus increases rapidly, and the oesophagus usually bursts in the lower third, sending a stream of material into the mediastinum and often the pleural cavity as well. Presents with acute chest pain Operative repair is the mainstay in large perforations, Non-operative repair can be used in small perforations, with minimal septic load esp in case of perforations during flexible endoscopy.