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Postbariatric Surgery Hyperammonemia: A Rare Cause of Encephalopathy

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 ele...

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Autores principales: Castineira, Janyll, Goltser, Yevgeniya, Vila, Mark, Patel, Reepal, Croix, Peggy St., Ashe, Duane, Al-Andary, Salah, Halleman, Christopher, Alkurdi, Basem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6722362/
https://www.ncbi.nlm.nih.gov/pubmed/31620519
http://dx.doi.org/10.14309/crj.0000000000000119
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author Castineira, Janyll
Goltser, Yevgeniya
Vila, Mark
Patel, Reepal
Croix, Peggy St.
Ashe, Duane
Al-Andary, Salah
Halleman, Christopher
Alkurdi, Basem
author_facet Castineira, Janyll
Goltser, Yevgeniya
Vila, Mark
Patel, Reepal
Croix, Peggy St.
Ashe, Duane
Al-Andary, Salah
Halleman, Christopher
Alkurdi, Basem
author_sort Castineira, Janyll
collection PubMed
description 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.
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spelling pubmed-67223622019-10-16 Postbariatric Surgery Hyperammonemia: A Rare Cause of Encephalopathy Castineira, Janyll Goltser, Yevgeniya Vila, Mark Patel, Reepal Croix, Peggy St. Ashe, Duane Al-Andary, Salah Halleman, Christopher Alkurdi, Basem ACG Case Rep J Case Report 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. Wolters Kluwer 2019-07-22 /pmc/articles/PMC6722362/ /pubmed/31620519 http://dx.doi.org/10.14309/crj.0000000000000119 Text en © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Case Report
Castineira, Janyll
Goltser, Yevgeniya
Vila, Mark
Patel, Reepal
Croix, Peggy St.
Ashe, Duane
Al-Andary, Salah
Halleman, Christopher
Alkurdi, Basem
Postbariatric Surgery Hyperammonemia: A Rare Cause of Encephalopathy
title Postbariatric Surgery Hyperammonemia: A Rare Cause of Encephalopathy
title_full Postbariatric Surgery Hyperammonemia: A Rare Cause of Encephalopathy
title_fullStr Postbariatric Surgery Hyperammonemia: A Rare Cause of Encephalopathy
title_full_unstemmed Postbariatric Surgery Hyperammonemia: A Rare Cause of Encephalopathy
title_short Postbariatric Surgery Hyperammonemia: A Rare Cause of Encephalopathy
title_sort postbariatric surgery hyperammonemia: a rare cause of encephalopathy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6722362/
https://www.ncbi.nlm.nih.gov/pubmed/31620519
http://dx.doi.org/10.14309/crj.0000000000000119
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