Background:Internal fi stula with adjacent viscera during acute pancreatitis is a rare complication. Due to their anatomic localization, colon, duodenum or stomach may be involved. Pancreatico-colonic fi stula is associated with a higher septic risk and surgery is usually mandatory. Results and main fi ndings:We report a new case in 71-year-old man diagnosed by CT with rectal water soluble contrast media and managed conservatively. To our knowledge, this is the second case in the literature treated in this way. Conclusion:Conservative treatment may be offered to selected patients who have a rapid improvement of symptoms associated with a signifi cant regression of the collection.

Primary aortoduodenal fistula (ADF) is a serious life-threatening condition.Unlike secondary ADF which occurs in patients who had previous aortic prosthetic reconstruction, primary ADF is uncommon. Its diagnosis is often unsuspected until surgery or postmortem. We report a rare case of primary ADF presenting as massive gastrointestinal bleeding.

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we report the case of a 61-year-old male patient who was admitted with abdominal pain, vomiting and constipation. he had a past medical history of epidermoid lung cancer .computed tomography revealed distended stomach with mural bowel thickening. it was peroperatively two small-bowel metastasis from lung cancer that we resect.