D-Lactic acidosis is an unique complication of jejunoileal bypass occu
rring because of alteration of colonic bacterial flora with selective
proliferation of D-lactate-producing bacteria. The D-lactate accumulat
ion in the serum is associated with encephalopathy, which responds to
oral antibiotic drugs in most patients. Because gastroenterologists ma
y encounter such patients for some time to come, we report a new case
and review the literature.