A 34-year-old man known schizophrenic sustained a through and through Thoraco-abdominal gunshot injury which resulted in a penetrating injury to the splenic flexure, a shattered stomach, transected pancreas and a diaphragmatic injury with a chest wall wound. He underwent a laparotomy with repair of all his hollow viscus injuries, spelenectoym, distal pancreatectomy with drainage. His condition was later complicated with feculent discharge through the anterior chest wall bullet wound once he started oral intake. CT abdomen confirmed the presence of a gastro-colo-cutaneous fistula which was managed with drainage of a peri-pancreatic fluid collection and supportive care. He responded well and his fistula closed up without further complications.
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