Hyperammonemic Encephalopathy: A Complication of Gastric Bypass Surgery

Varun Reddy; Jinal K Patel; Dilendra Weerasinghe; Johnathan Frunzi

doi:10.7759/cureus.9864

Hyperammonemic Encephalopathy: A Complication of Gastric Bypass Surgery

Cureus. 2020 Aug 19;12(8):e9864. doi: 10.7759/cureus.9864.

Authors

Varun Reddy¹, Jinal K Patel², Dilendra Weerasinghe³, Johnathan Frunzi²

Affiliations

¹ Internal Medicine, Medical Center of Trinity, Trinity , USA.
² Internal Medicine, Medical Center of Trinity, Trinity, USA.
³ Surgery, Medical Center of Trinity, Trinity, USA.

Abstract

Hyperammonemia is a metabolic abnormality characterized by elevated levels of ammonia in the blood. This case report illustrates a 72-year-old Caucasian female with a history of prior gastric bypass surgery done 15 years ago, who was admitted multiple times for acute encephalopathy over the course of a few months. The patient was found to have a gastro-gastric fistula seen on a CT scan of the abdomen, which was the culprit of her acute encephalopathy. The patient underwent fistula closure via esophagogastroduodenoscopy.

Keywords: ammonia; astrocyte swelling; blood-bezoar; gastro-gastric fistula; hyperammonemia; hyperammonemia-encephalopathy; roux-en-y gastric bypass.

Publication types

Case Reports

Grants and funding

This research was supported in part by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities.