Malignant duodenocolic fistulas: a case report and review of the literature.

A case of primary malignant duodenocolic fistula is presented. Colonic carcinoma is the most common etiology of this entity. clinical features include diarrhea, weight loss, anemia, and feculent vomiting. Review of the literature indicates that the treatment of choice is a right hemicolectomy with a pancreaticoduodenectomy or segmental duodenectomy if the disease is localized. Forty-six percent of patients undergoing this procedure have been reported to be alive more than 2.5 years later. If the disease is disseminated, the best palliative procedure appears to be a right hemicolectomy with a partial duodenectomy. The early morbidity and mortality associated with this latter procedure have been attributed most often to dehiscense of the duodenal closure.