AIM:To further elucidate the pathogenesis andmechanisms of the high risk of gallstone formation inCrohn’s disease.METHODS:Gallbladder bile was obtained from patientswith Crohn’s disease who were admitted for electivesurgery (17 with ileal/ileocolonic disease and 7 withCrohn’s colitis).Fourteen gallstone patients servedas controls.Duodenal bile was obtained from tenhealthy subjects before and after the treatment withursodeoxycholic acid.Bile was analyzed for biliary lipids,bile acids,bilirubin,crystals,and crystal detection time(CDT).Cholesterol saturation index was calculated.RESULTS:The biliary concentration of bilirubin wasabout 50% higher in patients with Crohn’s disease thanin patients with cholesterol gallstones.Ten of the patientswith Crohn’s disease involving ileum and three of thosewith Crohn’s colitis had cholesterol saturated bile.Fourpatients with ileal disease and one of those with colonicdisease displayed cholesterol crystals in their bile.About1/3 of the patients with Crohn’s disease had a shortCDT.Treatment of healthy subjects with ursodeoxycholicacid did not increase the concentration of bilirubin induodenal bile.Several patients with Crohn’s disease,with or without ileal resection/disease had gallbladderbile supersaturated with cholesterol and short CDT andcontained cholesterol crystals.The biliary concentrationof bilirubin was also increased in patients with Crohn’scolitis probably not due to bile acid malabsorption.CONCLUSION:Several factors may be of importance forthe high risk of developing gallstones of both cholesteroland pigment types in patients with Crohn’s disease. AIM: To further elucidate the pathogenesis and mechanisms of the high risk of gallstone formation in Crohn’s disease. METHODS: Gallbladder bile was obtained from patients with Crohn’s disease who were admitted for elective surgeries (17 with ileal / ileocolonic disease and 7 with Crohn’s colitis) .Fourteen gallstone patients servedas controls. Duodenal bile was obtained from ten subjects before and after the treatment withursodeoxycholic acid. Bile was analyzed for biliary lipids, bile acids, bilirubin, crystals, and crystal detection time (CDT). Cholesterol saturation index was calculated .RESULTS: The biliary concentration of bilirubin wasabout 50% higher in patients with Crohn’s disease thanin patients with cholesterol gallstones. Ten of the patients with Crohn’s disease involving ileum and three of those with Crohn’s colitis had cholesterol saturated bile. Fourpatients with ileal disease and one of those with colonic diseases their bile.About1 / 3 of the patients with Cro hn’s disease had a shortCDT. Treatment of healthy subjects with ursodeoxycholic acid did not increase the concentration of bilirubin induodenal bile. Several patients with Crohn’s disease, with or without ileal resection / disease had gallbladderbile supersaturated with cholesterol and short CDT andcontained cholesterol crystals. The biliary concentrationof bilirubin was also increased in patients with Crohn’scolitis probably not due to bile acid malabsorption.CONCLUSION: Several factors may be of fortific high risk of developing gallstones of both cholesteroland pigment types in patients with Crohn’s disease.