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Papers of the Week

2020 Mar 30

BMJ Case Rep



Non-cirrhotic hyperammonaemia: are we missing the diagnosis?


Lee Y L, Pang S, Ong C
BMJ Case Rep. 2020 Mar 30; 13(3).
PMID: 32234862.


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.