Malignant duodeno-colic fistula

Abstract

Colo-duodenal fistula is a rare complication of gastro-intestinal malignancy and inflammatory bowel disease. The fistula often results in diarrhea and vomiting with dramatic weight loss. Vomiting may be feculent or truly fecal associated with foul smelling eructation. We present an unusual case of colonic carcinoma, where a 61-year-old female patient presented with pain abdomen and vomiting secondary to a malignant colo-duodenal fistula near the hepatic flexure. Ultrasonography showed a mass in the hepatic flexure area, and invasive adenocarcinoma was confirmed on histology from biopsy obtained during colonoscopy. Coloduodenal fistulae from colonic primaries are rare, but early diagnosis may allow curative surgery.

Keywords

• adenocarcinoma colon
• coloduodenal fistula
• gastrointestinal fistula