Why does hepatic encephalopathy sometimes manifest after a portosystemic shunt is surgically created in patients with liver cirrhosis?

💡 Explanation

Hepatic encephalopathy can occur post-shunt because ammonia, normally converted to urea in the liver, bypasses this detoxification process, leading to elevated blood ammonia levels that affect brain function; therefore, the lack of hepatic detoxification causes the observed neurological symptoms, rather than increased urea cycle activity, enhanced catabolism, or reduced gluconeogenesis.

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