Hyperammonemic encephalopathy related to ureterosigmoidostomy.
Urinary diversion to the colon may produce a metabolic encephalopathy with elevated blood ammonia levels. The condition resembles hepatic encephalopathy but can occur without obvious liver disease. The patient described herein also had a computed tomographic scan showing diffuse brain swelling and superficial contrast enhancement. The condition responds rapidly to lowering of the blood ammonia level and requires a high level of suspicion for diagnosis in the patient who has undergone urinary diversion and has an unexplained metabolic encephalopathy.
D000328:Adult; D000641:Ammonia / Q000097:blood*; D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D008659:Metabolic Diseases / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014547:Urinary Diversion / Q000009:adverse effects*
D000641:Ammonia