Abstract
A hepatic abscess is a potentially life-threatening condition that can lead to major complications if left untreated. One of the rarest complications of hepatic abscesses is rupture into adjacent organs like the duodenum, stomach, and colon. We report a case of an elderly male patient with a hepatic abscess that ruptured into the duodenum and colon, forming fistulous connections. To the best of our knowledge, this is the only reported case of hepatic abscess with simultaneous hepatoduodenal and hepatotoxic fistulas, confirmed radiologically and endoscopically. This report signifies the need for a high level of vigilance for extremely rare complications in relatively common conditions.