Extrahepatic portosystemic shunts as an unusual but treatable cause of hyperammonemic encephalopathy in a noncirrhotic patient - a case report.
Jordi Kühne EscolàJens M TheysohnYan LiMichael ForstingPhilipp CapetianJens VolkmannChristian LangeCarlos M QuesadaMartin KöhrmannBenedikt FrankChristoph KleinschnitzPublished in: Therapeutic advances in neurological disorders (2022)
We report a case of hyperammonemic encephalopathy due to extrahepatic portosystemic shunts in a noncirrhotic patient. A 79-year-old woman suffered from episodic confusion, disorientation, dysphasia and fluctuating level of consciousness. Electroencephalography (EEG) showed encephalopathic changes and serum levels of ammonia were elevated. Further investigation revealed mesenterorenal and mesenterocaval shunts, which had possibly evolved after pancreatic surgery 5 years ago. After shunt obliteration, the symptoms completely resolved, ammonia levels dropped to the normal range and EEG findings normalized. Clinicians should be aware of this rare but treatable cause of encephalopathy in noncirrhotic patients.
Keyphrases
- early onset
- end stage renal disease
- case report
- functional connectivity
- newly diagnosed
- ejection fraction
- minimally invasive
- resting state
- working memory
- chronic kidney disease
- prognostic factors
- palliative care
- room temperature
- peritoneal dialysis
- coronary artery bypass
- single cell
- anaerobic digestion
- depressive symptoms
- atrial fibrillation
- pulmonary hypertension
- coronary artery disease
- sleep quality
- patient reported
- surgical site infection