Partial biliary obstruction with cholangitis producing a blind loop syndrome.

The frequency with which bacterial cholangitis complicates choledocholithiasis or benign postoperative biliary strictures has been the subject of several studies (Elkeles and Mirizzi, 1942; Anderson and Priestley, 1951; Edlund, Mollstedt, and Ouchterlony, 1959; Scott and Khan, 1967). The magnitude of the bacterial population present in this condition had, however, been crudely assessed until in a recent study it was shown that quantitatively the bacterial population of an infected bile duct per gram of contents rivalled that of the colon as far as aerobic organisms were concerned (Scott and Khan, 1967). It therefore seemed possible that as bacteria multiplied in bile and as the heavily infected bile was secreted into the intestine functional changes would be produced which would parallel those which follow infestation of the small bowel in the 'blind loop syndrome'. In this paper we are reporting a study of 1 patients with partial biliary obstruction and cholangitis. We have employed techniques of investigation which have proved helpful in understanding the typical blind loop syndrome and have obtained results that suggest that such a parallel situation may indeed be present.