A child who presented at age 9 months with steatorrhoea and malnutrition is described. After an initial period of intravenous feeding it was found that oral gentamicin led to a reduction of clinical steatorrhoea and an increase in weight, and so gentamicin was continued for 18 months. Investigation showed severe villous atrophy without pronounced inflammatory cell infiltrate and with no increase in intraepithelial lymphocytes. The villous atrophy was not present in the duodenum but started in the jejunum. The small-intestine was radiologically dilated throughout its length. It is suggested that this structurally-abnormal gut acted as a stagnant loop and exacerbated the steatorrhoea.