TY - JOUR T1 - Recurrent ascending cholangitis due to small intestinal bacterial overgrowth, gastrointestinal dysmotility and an afferent loop JF - Frontline Gastroenterology JO - Frontline Gastroenterol SP - 282 LP - 287 DO - 10.1136/flgastro-2013-100309 VL - 4 IS - 4 AU - Elizabeth Harrison AU - Wendy Stokes AU - Joanne E Martin AU - Sheldon C Cooper Y1 - 2013/10/01 UR - http://fg.bmj.com/content/4/4/282.abstract N2 - 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. ER -