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Gastrocolic fistula is a rare complication of the percutaneous endoscopic gastrostomy (PEG) placement procedure. This complication occurs due to penetration of interposed colon when a PEG tube is placed into the stomach. It can go unrecognized, becoming evident only when a tube replacement is performed or tube migration occurs. We report a case of severe, intractable diarrhea occurring about one month after the PEG procedure in a patient with severe traumatic brain injury. We present our case and discuss its significance with the aim of raising clinicians’ awareness of this rare condition.