Introduction Gastropulmonar fistulas are an extremely rare entity that has gained interest nowadays due to its association with bariatric surgery. Infection by Mycobacterium Abscessus is also a rare entity that needs specific conditions in order to present in humans. We describe the case of a patient with history of multiple gunshot injuries in thorax and abdomen that resolve after various interventions and years after present recurrent hemoptysis, left hemithorax infiltrates and positive BK persist even though antiTB treatment