Complete biliary fistula of four years duration with hemorrhagic tendency

Treatment of Biliary-Tract Disease

“…50 These authors noted that in a patient suffering from a complete biliary fistula of four years' duration, in spite of the administration of constantly increasing amounts of a vitamin K preparation and bile salts by mouth, there were marked variations in the plasma prothrombin, the Ivy bleeding time and the serum-volume index. Such a vitamin A lack may be due either to faulty absorption because of the relative lack of bile acids entering the small intestine or to an inadequate dietary intake, and is entirely comparable to similar deficiencies in other fat-soluble vitamins commonly observed in the course of hepatic disturbances.…”