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

Abstract

Ever since the shunt device became the gold standard treatment for hydrocephalus, complications due to infections and mechanical problems have increased while lives have been saved. In addition, abdominal complications have become an important issue as the peritoneum is now the main place to insert the distal catheter. The most common complications were abdominal pseudocyst, distal catheter migration, inguinal hernia, catheter disconnection, and intestinal obstruction. The pediatric population is more prone to develop most of these complications due to their rapidly growing body, weaker abdominal musculature, and increased intraabdominal pressure. The goal of this review was to study the main aspects associated with abdominal complications after ventriculoperitoneal shunt (VPS) insertion, including the pathophysiology, epidemiological aspects, as well as the rationale for management and prevention according to the current "state-of-the-art." It is paramount to recognize the risk factors associated with various types of complications to manage them properly.

Intracardial migration of a ventriculoperitoneal shunt

“…Implantation of ventriculoperitoneal shunts is a common therapeutic option to treat hydrocephalus. In addition to the most common complications such as infection, abdominal pseudocysts, ascites, hernia, intestinal obstruction, shunt-fracture/dislocation,1 intracardial migration of the distal catheter like in this case is rare 2…”

Case Report: A Rare Case of Fourth Ventricle to Spinal Subarachnoid Space Shunt Migration: Surgical Pearl and Literature Review

“…Complications of migration of lumboperitoneal shunt are frequent ( 16 , 17 ). General complications are similar to ventriculoperitoneal shunt, i.e., abdominal pseudocyst, distal catheter migration, inguinal hernia, catheter disconnection, infection, and intestinal obstruction ( 18 ).…”

Rare complication of ventriculoperitoneal shunt: Ectopic distal catheter in a Grynfeltt hernia – case report

“…Among the known nonmechanical failures are usually: infections and complications in the distal compartment of the system, such as ascites, abdominal pseudocyst, herniations, intestinal obstructions, pleural effusion, in addition to other complications described in the literature, which are less frequently found. [ 4 , 8 ] The most recurrent complications are the infectious and the obstructive causes. [ 5 ] Studies indicate that these can be caused by tissue debris, obstruction in the choroid plexus, presence of clot, infection, distal catheter migration, localized immune response to the tube, distal obstruction, and pseudocyst formation.…”