Unmasking Hyperammonemia: Psychomotor Slowing as a Diagnostic Trigger During PEG and Enteral Nutrition.

Am SurgJun 9, 2026 (epub)
Case ReportGastroenterologyGeneral Surgery

Xiaoyi Zhao, Yue Shen, Qiang Zhan

✦ AI-curated · Sources linked

Case in brief

A 63-year-old woman experienced severe hyperammonemia and psychomotor slowing after undergoing percutaneous endoscopic gastrostomy (PEG) and continuous enteral nutrition for anxiety-related feeding difficulties. Despite normal neuroimaging, her plasma ammonia levels reached 117.6 μmol/L. The condition was resolved by removing the PEG and switching to a semi-liquid oral diet, which normalized her ammonia levels and cognitive function.

Diagnostic / clinical pearl

Clinicians should consider unexplained psychomotor slowing as a potential indicator of hyperammonemia in patients receiving long-term enteral nutrition, prompting timely evaluation and intervention.

Why it matters

This case underscores the importance of monitoring for metabolic complications in patients on enteral feeding, particularly those with underlying vulnerabilities.

Source

PubMed · PMID 42266008

Published in Am Surg. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

ShareTelegramLinkedIn

AI-generated summaries may contain errors or omissions. Verify clinically important information with the original publication.

More in Gastroenterology

Clinical ResearchHematology

Ponatinib-Blinatumomab or Imatinib-Chemotherapy for Adult Ph-Positive ALL.

This multicenter, phase 3 randomized trial compared frontline ponatinib plus blinatumomab with imatinib plus chemotherapy in adults with Philadelphia-positive acute lymphoblastic leukemia.

N Engl J MedOct 15, 2026Read summary
Clinical ResearchHematology

Efficacy and safety of mitapivat in patients with sickle cell disease (RISE UP): a phase 3, double-blind, global, randomised, placebo-controlled trial.

RISE UP was a phase 3, double-blind, global, randomised, placebo-controlled trial conducted at 69 sites in 15 countries. It evaluated twice-daily mitapivat in patients older than 16 years with sickle cell disease…

LancetOct 24, 2026Read summary
Clinical ResearchRheumatology

Ianalumab for the Treatment of Patients with Sjögren's Disease.

Two 52-week, double-blind, randomized, placebo-controlled phase III trials evaluated monthly or less frequent ianalumab in patients with active Sjögren's disease.

N Engl J MedOct 22, 2026Read summary

Want this personalized?

Stop searching the literature. Choose what you follow and xxcode will build your personalized medical digest.

  • Your specialties
  • Your filters and thresholds
  • Clinical Research + Case Reports, tuned separately
  • Automatic weekly delivery
  • Audio and text
Create my personalized digestSee plans

Prefer listening? Personalized audio digests are available with Pro.

Stay updated for free

Get the 3 most interesting publications in one specialty each week.

Weekly email. Unsubscribe anytime.