Nonfatal Hyperammonemic Encephalopathy as a Late Complication of Roux-en-Y Gastric Bypass

Abstract EN

Roux-en-Y gastric bypass (RYGB) is the most common weight loss procedure performed in the US.

Gastric bypass–related hyperammonemia (GaBHA) is a potentially fatal entity, characterized by encephalopathy associated with hyperammonemia and various nutritional deficiencies, which can present at variable time intervals after RYGB.

Twenty-five cases of hyperammonemic encephalopathy after bariatric surgery have been previously reported in the literature.

We describe the case of a 48-year-old Hispanic woman with no prior history of liver disease, presenting with nonfatal hyperammonemic encephalopathy as a late postoperative complication 20 years after undergoing a RYGB.

Hyperammonemic encephalopathy in the absence of known hepatic dysfunction presents a diagnostic dilemma.

An early diagnosis and intervention are crucial to decrease morbidity and mortality.