Bacterial flora in the duodenum of patients after biliary fenestration

Abstract

Abstract Fasting duodenal aspirates were studied in 15 patients with a biliary fenestration, 5 patients with a single duodenal diverticulum, 1 patient with a biliary fenestration and duodenal diverticulum, and 11 control subjects. A colonic type of bacterial flora, consisting of coliforms, Clostridium welchii, and Streptococcus faecalis, was found in 10 patients with biliary fenestration, 4 patients with a duodenal diverticulum, the patient with a fenestration and duodenal diverticulum, and in 1 of the control subjects. A high incidence of deconjugation of biles salts (10 out of 15 patients) and of steatorrhoea (8 out of 15 patients) was noted in the patients with biliary fenestration, as well as in those with a duodenal diverticulum (5 and 3 patients out of 5 respectively). Above-normal serum-folate levels were observed in 3 subjects with coliform colonization. It is possible that vague abdominal symptoms which may be experienced by patients after biliary fenestration, may be due to the presence of an abnormal bacterial flora in the duodenum.