Palliative management of malignant duodenocolic fistula using a covered colonic stent: A case report

Malignant duodenocolic fistula caused by colon cancer is a rare complication that often leads to severe malnutrition and poor condition. Radical surgery is highly invasive and may not be feasible in patients with poor performance status. We report a case of a 73-year-old man with transverse colon cancer complicated by a duodenocolic fistula, who presented with fecal reflux into the upper gastrointestinal tract and severe hypoalbuminemia. Endoscopic examinations revealed a fistula between the duodenum and transverse colon with luminal stenosis. Because surgical treatment and chemotherapy were not feasible, palliative endoscopic treatment was selected. A covered colonic stent was placed to dilate the stenosis and seal the fistula. Following stent placement, fecal reflux disappeared, oral intake improved, and symptoms improved. Covered colonic stenting may be an effective and minimally invasive palliative option for malignant duodenocolic fistula in patients unsuitable for surgery.