Traumatic colopleural fistula presenting as tension fecohemopneumothorax and septic shock: A case report

A colopleural fistula represents a rare pathological communication between the colon and the pleural cavity, typically resulting from trauma, malignancy, or inflammatory bowel disease. One of the exceedingly rare complications of a fistula is fecopneumothorax, characterized by the presence of gas and fecal matter in the pleural space, which can lead to fatal sepsis if not diagnosed promptly. We report an instance of a traumatic colopleural fistula in a 49-year-old male who suffered multiple gunshot wounds to the chest. Despite emergent surgical intervention and intensive critical care management, the patient developed a fecohemopneumothorax and ultimately died from septic shock. This case emphasizes the necessity for early radiologic evaluation for enterothoracic fistulas in trauma patients exhibiting persistent sepsis and abnormal thoracic drainage.