Hyperammonemic encephalopathy associated with post‐radiotherapy vesicointestinal fistula following cervical cancer.

The majority of hyperammonemic encephalopathy is due to liver cirrhosis. However, urinary tract infection caused by urease‐producing bacteria increases ammonia in urine and can lead to hyperammonemic encephalopathy, especially in cases with obstructive uropathy and vesicointestinal fistula. This is...

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Publicado en:Journal of Obstetrics & Gynaecology Research Vol. 47; no. 8; pp. 2790 - 2794
Autores principales: Kato, Kumiko, Okumura, Keiko, Suzuki, Shoji, Matsuyama, Aika, Hirabayashi, Hiroki, Hattori, Ryohei
Formato: case study diagnostic images tables/charts Journal Article
Publicado: Wiley-Blackwell Aug2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2021
      vid: 47
      iid: 8
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/jog.14865
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        atl: Hyperammonemic encephalopathy associated with post‐radiotherapy vesicointestinal fistula following cervical cancer.
      aug:
        au:
          Kato, Kumiko
          Okumura, Keiko
          Suzuki, Shoji
          Matsuyama, Aika
          Hirabayashi, Hiroki
          Hattori, Ryohei
        affil: Department of Female Urology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
      sug:
        subj:
          Cervix Neoplasms Radiotherapy
          Radiotherapy Adverse Effects
          Treatment Complications, Delayed
          Intestinal Fistula Complications
          Brain Diseases, Metabolic Diagnosis
          Middle Age
          Female
          Diarrhea Etiology
          Sleepiness Etiology
          Ammonia Blood
          Urinalysis
          Urease
          Urinary Tract Infections
          Intestinal Fistula Surgery
          Nephrostomy, Percutaneous
          Middle Aged: 45-64 years
          Female
      ab: The majority of hyperammonemic encephalopathy is due to liver cirrhosis. However, urinary tract infection caused by urease‐producing bacteria increases ammonia in urine and can lead to hyperammonemic encephalopathy, especially in cases with obstructive uropathy and vesicointestinal fistula. This is the first case report of hyperammonemic encephalopathy in a cervical cancer patient associated with postradiotherapy vesicointestinal fistula. A 52‐year‐old woman developed diarrhea due to vesicosigmoidal fistula 14 years after radical hysterectomy and radiotherapy to treat cervical cancer. She refused urinary and/or fecal diversion. Twelve months after the diagnosis of fistula, she was admitted due to somnolence. Blood examination showed hyperammonemia without liver dysfunction. Urine culture showed Proteus rettgeri and Klebsiella pneumoniae. She recovered after intravenous antibiotics. Eight months after recovery, she was readmitted due to somnolence reoccurring with failed intravenous, but successful oral antibiotic treatment. She finally agreed to undergo percutaneous nephrostomy and hyperammonemia never recurred during 7 years of follow‐up.
      pubtype: Academic Journal
      doctype:
        case study
        diagnostic images
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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