Hyperammonemic encephalopathy related to ureterosigmoidostomy
R. H. Edwards
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.
