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At the dawn of 2018, we must still recognise that most postoperative stercoral fistulas should disappear from the clinical scene, at the same time as postoperative peritonitis, which is a generalised primitive form, hence the analogy of the respective conclusions. As soon as a significant stercoral fistula appears in a rural tropical environment, it is necessary to give the patient every chance by deciding to transfer him/her immediately to the nearest specialised medical-surgical digestive resuscitation centre. Indeed, the multiplicity and the gravity of the lesions, the frequency, the rapidity and the intensity of their repercussions on the vital functions, the complexity of their local, nutritional and general treatment require the presence and the permanent cooperation of a trained and coherent medicosurgical team where surgeons, resuscitators, anaesthetists and nurses, work in perfect harmony in a true department. The touchstone for the healing of a stercoral fistula is the primacy of the initial medical treatment.