Hyperammonemic encephalopathy after omega-loop gastric bypass for obesity: A case report and discussion

Hyperammonemic encephalopathy is a rare but potentially fatal condition, that can occur after obesity surgery.

A 43-year-old Caucasian woman, with history of omega-loop gastric bypass, with hydrops, dyspnoea and severe malnutrition was referred for evaluation. After admission to medical department, she experienced three episodes of coma, and biochemical investigations showed hyperammonemia, hypoalbuminemia and hyperglutaminemia. Etiological investigations were not in favour of a urea cycle disorder, but rather a nutritional catastrophe with severe malnutrition secondary to the omega-loop gastric bypass.

In patients with history of obesity surgery, encephalopathy symptoms should lead to look after hyperammonemia and malnutrition.

This report demonstrates the importance of ammonemia testing in case of neurological symptoms in patients with a history of obesity surgery.