Nonhepatic Hyperammonemic Encephalopathy: An Unmasked Urea Cycle Disorder in the Setting of Late Gastric Bypass Complication.

We present the case of a woman with nonhepatic hyperammonemic encephalopathy, a rare complication of bariatric surgery. Proposed mechanism include underlying urea cycle disorders and increased ammonia production. Clinically, states of hyperammonemia present with predominantly neurological symptoms of behavioral disturbances, lethargy, seizures, and coma. Given the high morbidity and mortality rate of nearly 40%, early recognition and treatment of the underlying mechanisms of hyperammonemia are crucial.