Acute hyperammonemic encephalopathy due to a portosystemic shunt in a non-cirrhotic adult patient.

OBJECTIVE: To report a successfully treated hyperammonemia due to a portosystemic shunt in adult patient. DATA SOURCE: A patient with an altered mental status due to severe elevated ammonia level because of a portosystemic shunt. CONCLUSIONS: Hyperammonemia is not always related to liver failure in critically ill patients, but should be considered in all unknown origins of an altered mental status. A portosystemic shunt can be the responsible for this phenomenon, and it has a newly treatment technique named plug-assisted retrograde transvenous obliteration (PARTO), which can be quickly performed with high technical success rate and clinical efficacy for the treatment of the splenorenal and/or gastrorenal shunt.