Abstract
Valproate induced hyperammonemic encephalopathy (VHE) is a severe adverse effect of medicine. An epileptic patient with an acute hyperammonemia after the addition of valproic acid to his treatment presented with acute mental status changes consistent with encephalopathy. Notably, plasma ammonia level was 2 times of the upper limit, despite normal liver function tests. Plasma valproic acid level was in the therapeutic range. His symptoms resolved with the discontinuation of valproic acid and L-carnitine administration. We discuss this case and review the possible mechanisms of valproic acid–associated encephalopathy and the efficacy of L-carnitine.
Highlights
Penetrating scrotal trauma usually results with injury to immediate structures including testis, urethra, vas deferens and vessels or adjacent nongenital structures
Schwarz and Blair reported a case of a 15 years old male who had a scrotal trauma caused by a broom handle which entered from left scrotum with an exit point through the abdominal wall along with liver laceration
Scrotal trauma accounts for less than 1% of all trauma-related injuries in children, because of the anatomic location and mobility of the scrotum[1]
Summary
Şanslı Bir Vaka: Bir Adolesanda Skrotumun Nadir Görülen Delici Yaralanması: Travmatik Delici İnşaat Demiri RaazimUnaivzearsnityKMareadibcaullFuatcu, lZtya, fDeerpaTrtümreknytıolmf Paedzi,atKriac aSunrgSeöryn, 0m65e0z0,, BAessleıvOlerz,bAankyaorağ,lTuu,rkYeıyldız Pehlivan, A. Gazi University Medical Faculty, Department of Pediatric Surgery, 06500, Besevler, Ankara, Turkey
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