{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:00:45Z","timestamp":1784739645476,"version":"3.55.0"},"reference-count":13,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Gastroenterol"],"abstract":"<jats:p>Introduction: Hepatic encephalopathy after liver surgery is an uncommon but serious complication. Case Presentation: We describe an unusual case of a patient with a history of uretero-sigmoidostomy who developed severe hepatic encephalopathy following hepatectomy for liver metastases of colorectal cancer. Mechanical ventilation, ammonia-lowering drugs and continuous veno-venous hemofiltration were required in order to reverse encephalopathy. As ammonia production is principally governed via hydrolysis of urea in the gut, it is hypothesized that ammonia reabsorption via the uretero-sigmoidostomy played a pivotal role in the clinical course of this patient. Conclusion: This report highlights the need for awareness for reabsorption of ammonia in case of a uretero-sigmoidostomy in order to avoid unnecessary complications.<\/jats:p>","DOI":"10.1159\/000552943","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:00:58Z","timestamp":1781193658000},"page":"252-257","source":"Crossref","is-referenced-by-count":0,"title":["Hyperammonemia after Liver Surgery: A Case Report of an Unanticipated Postoperative Challenge"],"prefix":"10.1159","volume":"20","author":[{"given":"Dan","family":"Koning","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathanja","family":"Schep","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8737-3923","authenticated-orcid":false,"given":"Jeroen","family":"Hagendoorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5724-6587","authenticated-orcid":false,"given":"Jelmer","family":"Oor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3872-5771","authenticated-orcid":false,"given":"Maaike A.","family":"Sikma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2010.10.001"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2304-3881.2014.09.01"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000000928"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-5347(17)60756-0"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.5173\/ceju.2015.01.459"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/BF01299870"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-5347(17)50606-0"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1023\/a:1022817632573"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.14309\/01.ajg.0000708804.43512.e7"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/s0025-6196(12)65343-9"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2006.05.058"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00366.2006"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-19558-3"}],"container-title":["Case Reports in Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000552943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T16:01:01Z","timestamp":1784736061000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000552943"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000552943","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32625414","asserted-by":"subject"}]},"ISSN":["1662-0631"],"issn-type":[{"value":"1662-0631","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]}}}