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

Figure 2

Graphical representation of serum ammonia level and associated events. Fluctuation of serum ammonia level during ICU course on this patient. Level of ammonia and mental status did not improve much with conventional treatment of hyperammonemia. The patient showed status epilepticus, which did not improve with midazolam and phenytoin and needed propofol drip to control the seizure. CT of the brain at that stage showed diffused cerebral edema.