The patient was a 64-year-old man who had received subtotal esophagectomy for esophageal cancer reconstructed by a gastric tube via the thoracic route. He was referred to our hospital in a state of shock, with hematemesis. The bleeding site was not detected with studies of emergent endoscopy and angiography. Massive hemorrhage persisting, an immediate emergent operation was performed. However we were not able to locate the site of bleeding during the operation, and unfortunately we failed to save him. Autopsy showed a peptic ulcer in the gastric pedicle had perforated the thoracic aorta. Ulcers occurring in the gastric pedicle are accompanied by a risk of development of perforation of adjacent important visceras.