Hyperammonemic encephalopathy after omega-loop gastric bypass for obesity: a case report and discussion
Abstract
BACKGROUND
Hyperammonemic encephalopathy is a rare but potentially fatal condition, that can occur after obesity surgery.
CASE REPORT
A 43-year-old Caucasian woman, with history of omega-loop gastric bypass, with hydrops, dyspnoea and severe malnutrition was referred for evaluation. After admission to medical department, she experienced three episodes of coma, and biochemical investigations showed hyperammonemia, hypoalbuminemia and hyperglutaminemia. Etiological investigations were not in favour of a urea cycle disorder, but rather a nutritional catastrophe with severe malnutrition secondary to the omega-loop gastric bypass.
DISCUSSION
In patients with history of obesity surgery, encephalopathy symptoms should lead to look after hyperammonemia and malnutrition.
CONCLUSION
This report demonstrates the importance of ammonemia testing in case of neurological symptoms in patients with a history of obesity surgery.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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