Salcedo Juan D, Goldstein Jordan S, Quinonez Jose M, Mosetti Maria Antonietta
Department of Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
University of Miami Miller School of Medicine, Miami, FL, USA.
Case Rep Gastrointest Med. 2019 Jul 1;2019:9031087. doi: 10.1155/2019/9031087. eCollection 2019.
Roux-en-Y gastric bypass (RYGB) is the most common weight loss procedure performed in the US. Gastric bypass-related hyperammonemia (GaBHA) is a potentially fatal entity, characterized by encephalopathy associated with hyperammonemia and various nutritional deficiencies, which can present at variable time intervals after RYGB. Twenty-five cases of hyperammonemic encephalopathy after bariatric surgery have been previously reported in the literature. We describe the case of a 48-year-old Hispanic woman with no prior history of liver disease, presenting with nonfatal hyperammonemic encephalopathy as a late postoperative complication 20 years after undergoing a RYGB. Hyperammonemic encephalopathy in the absence of known hepatic dysfunction presents a diagnostic dilemma. An early diagnosis and intervention are crucial to decrease morbidity and mortality.
Roux-en-Y胃旁路术（RYGB）是美国最常见的减肥手术。胃旁路术相关的高氨血症（GaBHA）是一种潜在的致命病症，其特征为与高氨血症相关的脑病和各种营养缺乏，可在RYGB术后不同时间间隔出现。此前文献中已报道了25例减肥手术后发生的高氨血症性脑病病例。我们描述了一名48岁无既往肝病病史的西班牙裔女性病例，该患者在接受RYGB手术20年后出现非致命性高氨血症性脑病，作为术后晚期并发症。在无已知肝功能障碍的情况下发生的高氨血症性脑病带来了诊断难题。早期诊断和干预对于降低发病率和死亡率至关重要。
