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November 1984

Hyperammonemic Encephalopathy Related to Ureterosigmoidostomy

Author Affiliations

From the Department of Neurology, University of California, San Francisco.

Arch Neurol. 1984;41(11):1211-1212. doi:10.1001/archneur.1984.04050220113029

• 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.

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