Lee Yi Lin, Pang Siying, Ong Caroline
Department of Surgical Intensive Care, Singapore General Hospital, Singapore
Department of Anaesthesiology Intensive Care and Pain Medicine, Tan Tock Seng Hospital, Singapore.
BMJ Case Rep. 2020 Mar 30;13(3):e233218. doi: 10.1136/bcr-2019-233218.
Hepatic encephalopathy secondary to hyperammonaemia is a known complication of chronic liver disease. In contrast, non-cirrhotic hyperammonaemia is a lesser-known entity that should be considered in a patient with acute encephalopathy as part of the diagnostic workup as prompt identification can help to avoid complications such as seizures and cerebral oedema. We present a case of a middle-aged woman who presented electively for a total pancreatectomy-duodenectomy with splenectomy, hepatico-jejunostomy, gastro-jejunostomy and developed encephalopathy on postoperative day 10 due to non-cirrhotic hyperammonaemia.
继发于高氨血症的肝性脑病是慢性肝病的一种已知并发症。相比之下，非肝硬化性高氨血症是一个鲜为人知的病症，在急性脑病患者的诊断检查中应予以考虑，因为及时识别有助于避免癫痫发作和脑水肿等并发症。我们报告一例中年女性病例，该患者因行全胰十二指肠切除术并脾切除术、肝空肠吻合术、胃空肠吻合术而择期就诊，术后第10天因非肝硬化性高氨血症而发生脑病。
