60-year-old woman diagnosed with antral stenosing gastric neoplasia. Subtotal gastrectomy with Roux-en-Y reconstruction was performed. On day +7 the patient deteriorated abruptly with the appearance of peritonitis, so she underwent urgent laparotomy, showing necrosis of the gastric lesser curvature and of the anterior face of the distal oesophagus. Transection and closure of the abdominal oesophagus and gastric stump, oesophageal exclusion with cervical oesophagostomy and feeding jejunostomy were performed, starting EN on day +1. The patient was discharged with NED by jejunostomy. Three months later, she was readmitted for reconstruction of the digestive tract, after colonoscopy and computed axial tomography, in which no data suggestive of tumour recurrence were observed. During surgery, multiple micronodules were observed in the transverse colon and in the region corresponding to the gastrohepatic omentum, with intraoperative pathology compatible with signet ring cells, so reconstruction was suspended and NED was maintained by jejunostomy indefinitely.

