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- Title
Recurrent Hyperammonemia During Enteral Tube Feeding for Severe Protein Malnutrition After Bariatric Surgery.
- Authors
Hendrikx, Louise; Brandts, Hans; van Borren, Marcel; de Boer, Hans
- Abstract
A 28-year-old female was admitted 2 years after gastric bypass limb distalization because of severe weight loss, fatigue, chronic diarrhea, massive edema, and a serum albumin of 10 g/L without proteinuria. A diagnosis of severe energy and protein malnutrition was made, and enteral tube feeding was started in combination with pancreatic enzyme supplementation every 3 h. Within 24 h after the start of tube feeding, she developed severe hyperammonemia. Tube feeding was stopped immediately, and this led to a normalization of serum ammonia levels within 8 h. When tube feeding was resumed, albeit at a lower rate and with preventive measures taken, hyperammonemia occurred again. The underlying causes and treatments of hyperammonemia during tube feeding are discussed.
- Subjects
FEEDING tubes; BARIATRIC surgery; HYPERAMMONEMIA; TUBE feeding; MALNUTRITION; GASTRIC bypass; EXOCRINE pancreatic insufficiency
- Publication
Obesity Surgery, 2019, Vol 29, Issue 12, p4127
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-019-04231-6