Postbariatric Surgery Hyperammonemia: A Rare Cause of Encephalopathy. Issue 7 (July 2019)

• Record Type: Journal Article
• Authors: Castineira, Janyll; Goltser, Yevgeniya; Vila, Mark; Patel, Reepal; Croix, Peggy St.; Ashe, Duane; Al-Andary, Salah; Halleman, Christopher; Alkurdi, Basem
• Is Part Of: ACG Case Reports Journal. Volume 6:Issue 7(2019)
• Publication Date: 2019-07
• DOI: 10.14309/crj.0000000000000119
• Languages: English
• ISSNs: 2326-3253

Abstract

Abstract : ABSTRACT: Hyperammonemic encephalopathy is an under-recognized and potentially fatal complication of Roux-en-Y gastric bypass surgery. We present a case of a 42-year-old woman with no known history of liver disease who experienced worsening encephalopathy 1 year after bariatric surgery. She presented with elevated ammonia and severe encephalopathy requiring intubation. A complete workup led to the diagnosis of a urea cycle disorder. The patient was managed with lactulose, ammonia scavenging agents, and nutritional supplementation with a favorable outcome. We report this case to increase awareness of this condition and urge providers to maintain a high clinical suspicion in the appropriate setting.