{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:36:02Z","timestamp":1792290962252,"version":"4.4.0"},"reference-count":24,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,7,10]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>A woman in her 60s developed diarrhoea after receiving amoxicillin\/clavulanic acid for biliary pancreatitis. After a diagnosis of <jats:italic>Clostridioides difficile<\/jats:italic> infection, she was treated with fidaxomicin. Despite initial improvement, her diarrhoea recurred, with increased severity, and repeated testing for <jats:italic>C. difficile<\/jats:italic> was negative. Further diagnostic workup yielded negative results for infectious, autoimmune or endocrine causes of diarrhoea, but a CT scan showed extensive walled-off necrosis (WON) due to the pancreatitis. Colonoscopy revealed two colonic fistulae, which were later confirmed by magnetic resonance cholangiopancreatography as pancreaticocolonic fistulae (PCF).<\/jats:p>\n               <jats:p>The patient was treated with the placement of a lumen-apposing metal stent, multiple endoscopic necrosectomies and broad-spectrum antibiotics. The patient\u2019s diarrhoea resolved after the reduction in the size of the WON. She was discharged in good condition after a prolonged hospital course. This case highlights the importance of considering PCF in patients with WON and persistent diarrhoea, as a rare complication of necrotising pancreatitis.<\/jats:p>","DOI":"10.1136\/bcr-2025-264903","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T09:25:18Z","timestamp":1753435518000},"page":"e264903","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Pancreaticocolonic fistulae: a rare cause of profound diarrhoea"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1285-7383","authenticated-orcid":false,"given":"Samy","family":"Mady","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"H\u00f6genauer","sequence":"additional","affiliation":[{"name":"Division 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