Malignant Colo-Duodenal Fistula: A Rare Complication of Carcinoma Colon

Abstract

Colo-duodenal fistula is a very infrequent complication of colon cancer that presents not only with severe clinical symptoms, but a poor prognosis due to locally advanced disease. It consists in a pathological communication between the lumen of the colon and duodenum. Presentation is generally sub-acute with majority of the patients presenting with non-specific abdominal pain, diarrhea, nausea and vomiting. The contact of duodenal bile salts with colonic mucosa frequently leads to diarrhea, so also duodenal colonization with colonic pathogens frequently leads to malabsorption, foul eructation and feculent vomiting. The diagnosis is established either by gastrointestinal contrast studies or contrast enhanced CT scan. Gastro-duodenoscopy and colonoscopy can demonstrate the fistulous communication and it can also be helpful in obtaining a histological diagnosis. We report a case of a 38-year-old male patient who presented to our gastroenterology clinic with complaints of diarrhea and abdominal pain and was diagnosed to have carcinoma colon with colo-duodenal fistula.