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

被引：0

作者：

Escola, Jordi Kuehne ^{[1
,2
]}

Theysohn, Jens M. ^{[3
]}

Li, Yan ^{[3
]}

Forsting, Michael ^{[3
]}

Capetian, Philipp ^{[4
,5
]}

Volkmann, Jens ^{[4
,5
]}

Lange, Christian ^{[6
]}

Quesada, Carlos M. ^{[1
,2
]}

Koehrmann, Martin ^{[1
,2
]}

Frank, Benedikt ^{[1
,2
]}

Kleinschnitz, Christoph ^{[1
,2
]}

机构：

[1] Univ Hosp Essen, Dept Neurol, Hufelandstr 55, D-45147 Essen, Germany

[2] Univ Hosp Essen, Ctr Translat Neuro & Behav Sci C TNBSI, Hufelandstr 55, D-45147 Essen, Germany

[3] Univ Hosp Essen, Inst Diagnost & Intervent Radiol & Neuroradiol, Essen, Germany

[4] Univ Hosp Wurzburg, Dept Neurol, Wurzburg, Germany

[5] Julius Maximilian Univ Wurzburg, Wurzburg, Germany

[6] Univ Hosp Essen, Dept Gastroenterol & Hepatol, Essen, Germany

来源：

THERAPEUTIC ADVANCES IN NEUROLOGICAL DISORDERS | 2022年 / 15卷

关键词：

extrahepatic shunt; hyperammonemia; hyperammonemic encephalopathy; noncirrhotic; PORTAL-SYSTEMIC ENCEPHALOPATHY; URINARY-TRACT-INFECTION;

D O I：

10.1177/17562864221097614

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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.

引用

页数：6

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