Article Text

PDF
Case report
Recurrent ascending cholangitis due to small intestinal bacterial overgrowth, gastrointestinal dysmotility and an afferent loop
  1. Elizabeth Harrison1,
  2. Wendy Stokes2,
  3. Joanne E Martin3,
  4. Sheldon C Cooper1,2
  1. 1Department of Gastroenterology, Dudley Group NHS Foundation Trust, Dudley, UK
  2. 2Clinical Nutrition and Intestinal Failure Team, Dudley Group NHS Foundation Trust, Dudley, UK
  3. 3Blizard Institute of Cell and Molecular Science Pathology Group, The Royal London Hospital, London, UK
  1. Correspondence to Dr Sheldon C Cooper, Department of Gastroenterology, Dudley Group NHS Foundation Trust, Dudley, UK DY1 2HQ; sheldon.cooper{at}dgh.nhs.uk, sheldon.cooper{at}nhs.net

Summary

We report a complex case involving an extremely rare cause of gastrointestinal dysmotility and an afferent loop, which together predisposed to the development of small intestinal bacterial overgrowth. The bacteria subsequently became multi-resistant. As a further consequence of the dysmotility, repeated bile duct reflux occurred despite the afferent loop being unobstructed. This bile duct reflux produced recurrent sepsis through repeated episodes of ascending cholangitis. Ultimately, the patient was referred to a National Small Intestinal Transplant Centre for consideration for enterectomy and subsequent transplantation. We describe the difficulties encountered in managing this unique case and discuss the underlying aetiology.

  • NUTRITION
  • MOTILITY DISORDERS

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.