Chemical Meningitis from Bile Reflux in a Lumbar-Gallbladder Shunt

Barami, Kaveh; Sood, Sandeep; Ham, Steven D.; Canady, Alexa

doi:10.1159/000028748

Cited by 15 publications

(6 citation statements)

References 6 publications

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“…Bernstein and Hsueh 3 described a fatal case involving VG shunt insertion for acute chemical ventriculitis from bile reflux. A case of bile reflux in a lumbar-gallbladder shunt has been reported by Barami et al, 1 although the outcome in that case was very good after revising the shunt. In contrast, Novelli and Reigel 13 reported no complications in a series of six patients treated with VG shunt insertion.…”

Section: Discussionmentioning

confidence: 91%

A rare, delayed complication of a ventriculogallbladder shunt

Fountas¹,

Kassam²,

Grigorian³

2007

FOC

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✓The use of the gallbladder as an alternative cerebrospinal fluid diversion site has been previously described in cases in which all other body cavities, such as the peritoneal cavity, right atrium, or pleural cavity, have been exhausted. Various ventriculogallbladder (VG) shunt complications have been described as well. In the present paper, the authors report on a rare, delayed VG shunt complication. A distal obstruction developed in a previously inserted VG shunt because of a large, radiolucent bile calculus. The presence of the VG shunt could be implicated in the pathogenetic mechanism of the bile calculus formation. The authors also review the pertinent literature.

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Section: Discussionmentioning

confidence: 91%

A rare, delayed complication of a ventriculogallbladder shunt

Fountas¹,

Kassam²,

Grigorian³

2007

FOC

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“…It should be mentioned that the gallbladder was used on very rare occasions as the site of CSF diversion coming from the lumbar spine in the so-called lumbar-gallbladder shunts. Complications such as chemical meningitis from bile reflux are reported in literature, which is a potential complication of cranial diversions, as well [8]. This raises the question of the biochemical effect that bile has on the cerebral tissue.…”

Section: Physiology Of Gallbladder Shuntingmentioning

confidence: 99%

“…It is highly possible that the meninges could be subject to the same process. In the case presented by Barami et al, the high acidity of the bile was also incriminated for the patient developing aseptic meningitis, encephalopathy, and severe lumbar arachnoiditis [8]. In the case reported by Bernstein, the effect of bile on the brain was evaluated during the autopsy.…”

Section: Physiology Of Gallbladder Shuntingmentioning

confidence: 99%

Evaluation of the ventriculocholecystic shunt—an overview of present practice in adult and pediatric hydrocephalus

2021

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In the context of hydrocephalus, there are a multitude of therapeutic options that can be explored in order to improve patient outcomes. Although the peritoneum is the current elected clinical solution, various receptacles have been utilized when experiencing contraindications. Along with the ventriculoatrial or ventriculopleural, the ventriculocholecystic shunt was also described as an alternative. In order to make a decision on a place for drainage, the surgeon must be knowledgeable on details from modern literature. The main target of this review was to summarize the currently available information on this topic and assess the status of the gallbladder as a viable option for cerebrospinal fluid diversion.

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“…This causes a high CSF flow rate until the pressure in the head becomes overly negative (siphoning) [22,38]. This is the presumed cause of complications involved in CSF shunt placement, including subdural hematomas [49,83], slit-ventricle syndrome [34,51], craniostenosis, and intracranial hypotension [8,35,37].…”

Section: Valvesmentioning

confidence: 99%

“…There have been reports that have proposed other organs as recipients for the diverted CSF. These include the bladder [108], duodenum or ascending colon, thoracic duct [58], and gall bladder [8,14,42,61,76,87,102,109]. These have failed to gain wide acceptance, however, and are seldom used in the clinical setting.…”

Section: Shunt Inserts and Accessoriesmentioning

confidence: 99%

Ventricular Shunts

Chabrerie

Black

2002

J Intensive Care Med

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Ventricular shunts are mechanical devices used in the treatment of hydrocephalus, by means of which cerebrospinal fluid (CSF) is diverted from the ventricles to other low-pressure body cavities. Over the last 50 years, mechanical shunting has become the cornerstone for the treatment of hydrocephalus with shunt valves evolving from simple differential valves to complex programmable valves. The chief complications of ventricular shunting include obstruction, infections, and overdrainage causing subdural hematomas and slit-ventricle syndrome. As the number of commercially available valve designs continues to grow, each new generation aims at reducing the likelihood of complications, especially those resulting from overdrainage. Several studies aimed at establishing the superiority of any valve design have been conducted. All have highlighted the advantages and shortcomings of most models without conclusively providing evidence for choosing one over another. As a result, choices still rest on individual and institutional preferences.

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Chemical Meningitis from Bile Reflux in a Lumbar-Gallbladder Shunt

Cited by 15 publications

References 6 publications

A rare, delayed complication of a ventriculogallbladder shunt

A rare, delayed complication of a ventriculogallbladder shunt

Evaluation of the ventriculocholecystic shunt—an overview of present practice in adult and pediatric hydrocephalus

Ventricular Shunts

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