Surgical emergency procedures remain the most unpredictable operations. In this paper we describe a case ofa 44-years-old male patient with sudden peptic ulcer perforation a few days before planned esophagectomy withsimultaneous reconstruction for suspected c neoplastic stricture of the lower oesophagus. Emergency laparotomyrevealed large perforated ulceration (3 cm) in the pre-pyloric area and another ulceration in the sub-cardiac region.Due to the high suspicion for oesophageal malignancy total gastrectomy with subtotal transhiatal oesophagectomywere performed. As the patient was in septic shock and required intensive treatment during the initial operation thedelayed esophageal reconstruction was planned. Described case shows complex natu...