Extrahepatic portosystemic shunts as an unusual but treatable cause of hyperammonemic encephalopathy in a noncirrhotic patient – a case report

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 an...

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Bibliographic Details
Published inTherapeutic advances in neurological disorders Vol. 15; p. 17562864221097614
Main Authors Kühne Escolà, Jordi, Theysohn, Jens M., Li, Yan, Forsting, Michael, Capetian, Philipp, Volkmann, Jens, Lange, Christian, Quesada, Carlos M., Köhrmann, Martin, Frank, Benedikt, Kleinschnitz, Christoph
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 2022
SAGE PUBLICATIONS, INC
SAGE Publishing
Subjects
Ammonia
Case Report
Case reports
EEG
Encephalopathy
Serum levels
Shunts
hyperammonemia
noncirrhotic
extrahepatic shunt
hyperammonemic encephalopathy
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Summary: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.
ISSN:1756-2864
1756-2856
1756-2864
DOI:10.1177/17562864221097614