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Related Experiment Videos

Hyperammonemia complicating mesenteric vein thrombosis.

A Blei, S Dux, I Grosskopf

    The American Journal of Medicine
    |February 1, 1986
    PubMed
    Summary
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    A rare case of hyperammonemic coma linked to mesenteric vein thrombosis was observed in a 69-year-old woman. Surgical intervention resolved the coma and normalized ammonia levels, suggesting a novel complication.

    Area of Science:

    • Gastroenterology
    • Internal Medicine
    • Critical Care Medicine

    Background:

    • Hyperammonemia, a condition of elevated blood ammonia, can lead to severe neurological dysfunction, including coma.
    • Mesenteric vein thrombosis (MVT) is a serious vascular emergency affecting blood flow in the intestines.
    • The interplay between MVT and hyperammonemia has not been previously documented.

    Observation:

    • A 69-year-old female presented with abdominal pain, dysphagia, and fever, progressing to hyperammonemic coma.
    • Laparotomy revealed MVT, necessitating partial intestinal resection.
    • Post-operatively, the patient recovered consciousness, and ammonia levels normalized.

    Findings:

    • This case represents the first reported instance of hyperammonemic coma complicating MVT.

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  • The resolution of hyperammonemia following surgical treatment suggests a direct link to the thrombotic event.
  • The potential role of venous shunting in the pathogenesis of this complication is hypothesized.

    • Implications:

    • This finding expands the known clinical spectrum of MVT complications.
    • It highlights the importance of considering metabolic derangements, such as hyperammonemia, in patients with abdominal vascular emergencies.
    • Further research into the mechanisms underlying hyperammonemia in MVT may reveal new diagnostic or therapeutic targets.