The patient was a 51-year-old female, underwent total gastrectomy for gastric cancer 6 years ago. She was admitted to a local hospital with the complaint of fever, the chest X-ray showed niveau in the left pleural cavity. Fecal material flowed out by drainage. Barium enema showed fistula of diaphragma from transverse colon. She was transferred to our hospital. Partial transverse colon resection and removal of the diaphragma fistula were performed. The colon tumor was histologically determined to be metastasis from gastric cancer with thoracic empyema.