Unusual cause of cholangitis and diarrhoea after cholecystectomy

[...]the exposure of the colonic bacteria to the biliary system resulted in cholangitis and the drainage of bile into the colon caused diarrhoea, as bile salts enter the colon, bypassing the enterohepatic circulation resulting in the local concentration of bile acid in the colon to exceed 3 to 5 mmol/l and thereby inhibiting colonic fluid and electrolyte absorption and accelerate transit, working as a laxative. Learning points Cholangitis and jaundice after cholecystectomy is most commonly due to retained common bile duct stones, but rarer causes like iatrogenic bile duct stricture and biliary enteric fistulas should always be considered.