Fatal Nonhepatic Hyperammonemia in ICU Setting: A Rare but Serious Complication following Bariatric Surgery

Table 3

Differential diagnosis of nonhepatic hyperammonemia based on [3–8].

SN	Ddx	Characteristics
1	Medications	Valproic acid, 5-FU
2	Infections	Urease-producing bacteria:
		(i) Proteus mirabilis
		(ii) Helicobacter pylori
		(iii) Cornebacterium, Klebsiella, and Morganella species
3	Surgery	(i) Lung transplant
		(ii) Bone marrow transplant
		(iii) Ureterosigmoidoscopy
		(iv) Portosystemic shunts
		(v) Bariatric surgery
4	Hyperalimentation	Increased nitrogen load in patient receiving parental nutrition
5	Errors in metabolism
	(a) Fatty acid oxidation defects
	(b) Urea cycle enzyme defects
	(c) Amino acid disorders
6	Gastrointestinal bleeding
7	Carnitine deficiency