Complete biliocolic fistula.

A case of postoperative complete biliocolic fistula is described. The patient had 10 daily voluminous motions of diarrhoea and lost 14 kg in weight in the course of two months. Increased faecal fat excretion was demonstrated. Treatment with oral tetracyclines resulted in cessation of the watery diarrhoea and some weight gain, but steatorrhoea persisted. Closure of the biliocolic fistula with re-established bile flow to the proximal small intestine cured the patient. A discussion of the case based on the present knowledge of bile salt metabolism and bile salt- bacterial interrelationship is presented.