The authors examine the clinical evolution of a patient with an oesophageal neoplasm with intraperitoneal liver metastases unnoticed in preoperative phase. Some months after the explorative operation, the patient first underwent a thoracotomy + a cervicostomy with monopolar exclusion of oesophagus because of a mediastinitis caused by a iatrogenic perforation during the attempt to place an oesophageal endoprosthesis; then he underwent a recanalization by presternal subcutaneous oesophago-colonplasty, stimulated by the good result of the surgical operation and by the patient's excellent clinical conditions after the mediastinitis event.