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Dogustan urolojik defektlerin veya mesane kanserinin tedavisi icin yapilan bir uriner diversiyon proseduru olan Ureterosigmoidostomi, eslik eden karaciger hastaliginin yoklugunda bile nadiren hiperammonemi ile seyredebilir. Burada, ureterosigmoidostomi sonrasi 43 yil hiperammonik ensefalopati gelisen 47 yasinda bir erkek hastayi sunuyoruz. Bu nedenle, ureteroopigmoidostomi sonrasi hiperammonemik ensefalopati, kritik bakim ortamlarinda degismis bilincliligin ayirici tanisinda dikkate alinmasi gereken iyatrojenik, ancak tedavi edilebilir bir problemdir.

Non-cirrhotic Hyperammonemia causing altered sensorium in a patient who underwent Urinary diversion 43 years ago.