PT  - JOURNAL ARTICLE
AU  - Elizabeth Harrison
AU  - Wendy Stokes
AU  - Joanne E Martin
AU  - Sheldon C Cooper
TI  - Recurrent ascending cholangitis due to small intestinal bacterial overgrowth, gastrointestinal dysmotility and an afferent loop
AID  - 10.1136/flgastro-2013-100309
DP  - 2013 Oct 01
TA  - Frontline Gastroenterology
PG  - 282--287
VI  - 4
IP  - 4
4099  - http://fg.bmj.com/content/4/4/282.short
4100  - http://fg.bmj.com/content/4/4/282.full
SO  - Frontline Gastroenterol2013 Oct 01; 4
AB  - 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.