Failure to thrive and severe malnutrition secondary to duodenocolic fistula: A case report

INTRODUCTION AND IMPORTANCE: Duodenocolic fistula (DCF) is a rare surgical condition. Patients usually develop chronic nonspecific symptoms. DCF has major consequences on patients' health and quality of life. This report describes an adult male patient with chronic nonspecific gastrointestinal and malnutrition symptoms. After several attempts to establish a diagnosis, DCF was discovered incidentally during abdominal exploration. CASE PRESENTATION: We are presenting a case of a 33-year-old male patient with a long-standing history of malnutrition and failure to thrive. He underwent multiple investigations in several hospitals with no definitive diagnosis. All investigations were repeated in our hospital which were inconclusive. Two years after the first presentation to our hospital, the patient presented to the emergency room with bowel obstruction. During his admission, he was thoroughly investigated. His hospital admission included 2 surgeries where eventually a duodenocolic fistula was identified and surgically resected. All the patient's symptoms improved thereafter. CONCLUSION: This case highlights some of the obstacles in diagnosing and managing DCF. Early diagnosis is essential to avoid serious complications. Management options should be tailored to the underlying cause and patient conditions. Regardless of the cause of the fistula, surgery is the only treatment.