Incisional Hernia Following Ventriculoperitoneal Shunt Positioning

Abstract

Incisional hernia represents a rare complication after ventriculoperitoneal shunt positioning due to failure of the fascial suture in the site of abdominal entrance of ventriculoperitoneal catheter. Clinical presentation can be extremely variable, according to patient's performance status, herniated material constitution (i.e. mesenteric fat, bowel loops or both) and complication occurrence (e.g. strangulation or intestinal obstruction). Early diagnosis is fundamental in order to surgically repair the defect and prevent further complications. We present the case of a paucisymptomatic incisional hernia following ventriculoperitoneal shunt positioning. Diagnosis was made by means of ultrasound and confirmed by means of computed tomography. The patient was successfully managed by means of surgical repositioning of herniated loop and re-suture.

Abdominal Complications Related to Ventriculoperitoneal Shunt Placement: A Comprehensive Review of Literature

“…The most accepted theory of physiopathology is related to increased intraabdominal pressure due to CSF in the peritoneal cavity [25]. Incisional hernia was also reported [16].…”

“…Although abdominal complications related to ventriculoperitoneal shunt (VPS) have been considered rare with heterogeneous presentation, incidence varied over the last decades, ranging from 5% to almost half of cases [16][17][18][19][20][21][22]. Primarily, abdominal complications related to VPS can be associated with infection or mechanical problems with the shunt.…”

Robot‐assisted incisional hernia repair in a super obese patient after placement of a ventriculoperitoneal shunt – a video vignette

“…Reports of the development of large incisional hernias as a consequence of insertion of a ventriculoperitoneal shunt (VPS) are anecdotal . Common complications are infections, peritoneal pseudocysts and volvulus .…”