Review of the Management  of Peroral Extrusion of  Ventriculoperitoneal Shunt Catheter

Ghritlaharey, Rajendra K

doi:10.7860/jcdr/2016/23372.8920

Cited by 12 publications

(21 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Insertion of VPS in not without complications which are well described in the literature. [ 34 35 36 ] By doing aspiration along with cranioplasty, we could avoid a VPS in 10 out of 11 patients.…”

Section: Discussionmentioning

confidence: 99%

The Conundrum of Ventricular Dilatations Following Decompressive Craniectomy: Is Ventriculoperitoneal Shunt, The Only Panacea?

Kutty

Sreemathyamma

Sivanandapanicker

et al. 2018

Journal of Neurosciences in Rural Practice

View full text Add to dashboard Cite

Introduction:Ventriculomegaly and hydrocephalus (HCP) are sometimes a bewildering sequela of decompressive craniectomy (DC). The distinguishing criteria between both are less well defined. Majority of the studies quoted in the literature have defined HCP radiologically, rather than considering the clinical status of the patient. Accordingly, these patients have been treated with permanent cerebrospinal fluid (CSF) diversion procedures. We hypothesize that asymptomatic ventriculomegaly following DC should undergo aspiration with cranioplasty and be followed up regularly.Materials and Methods:All patients with post-DC who were scheduled for cranioplasty and satisfied the radiological criteria for HCP were included. These patients were categorized into two groups. Group 1 included ventriculomegaly with clinical signs attributable to HCP and Group 2 constituted ventriculomegaly but no clinical signs attributable to HCP. All patients in Group 1 underwent ventriculoperitoneal shunt followed by cranioplasty, whereas all patients in Group 2 underwent cranioplasty along with simultaneous ventriculostomy and temporary aspiration of the lateral ventricle. All patients were regularly followed as the outpatient basis.Results:There were 21 patients who developed ventriculomegaly following DC. There were 10 patients in Group 1 and 11 patients in Group 2. The average duration of follow-up was from 6 months to 2 years. Two patients in the shunt group - (group 1) had over drainage and required revision. One patient in aspiration group - (group 2) required permanent CSF diversion.Conclusions:Cranioplasty with aspiration is a viable option in selected group of patients in whom there is ventriculomegaly but no signs or symptoms attributable to HCP.

show abstract

Section: Discussionmentioning

confidence: 99%

The Conundrum of Ventricular Dilatations Following Decompressive Craniectomy: Is Ventriculoperitoneal Shunt, The Only Panacea?

Kutty

Sreemathyamma

Sivanandapanicker

et al. 2018

Journal of Neurosciences in Rural Practice

View full text Add to dashboard Cite

show abstract

“…[ 1 5 17 18 19 ] However, the rigid and hard catheters are not the only cause. From the literature, it was observed only two (9.5%) cases used Raimondi coil spring catheter,[ 4 8 ] five (23.8%) cases (including the present case) used Chhabra-slit-spring silicone catheter,[ 5 7 10 17 ] and one (5%) case used Holter valve with soft tube. [ 6 ] The rest did not mention the type of shunt that was used.…”

Section: Discussionmentioning

confidence: 89%

Upward migration and peroral extrusion of a peritoneal shunt catheter: Case report and review of the literature

et al. 2017

View full text Add to dashboard Cite

Background:Various complications after ventriculoperitoneal (VP) shunt surgery have been reported, but peroral extrusion of peritoneal catheter is an extremely rare complication, and only 20 cases have been reported since 1987. The pathophysiology still remains unclear and the management is challenging.Case Description:A 5-year-old boy presented with a catheter coming out of his mouth. The boy had a posterior fossa tumor surgery and had VP shunt insertion 1 year earlier. Clinical signs and imaging studies showed that the distal end of the catheter had perforated the gaster and migrated upward and extruded through the mouth. Emergency removal of the shunt and proper treatment were done and he made uneventful recovery.Conclusion:Peroral extrusion of VP shunt is extremely rare. Clinicians should be aware of this complication. With early diagnosis and proper management, the prognosis for good recovery is excellent, with only two deaths being reported in the literature. Complication of shunt extrusion is difficult to avoid, but knowing the risk factors, pathophysiology and proper management will decrease the morbidity and mortality of such cases.

show abstract

“…Colon is the most common site for hollow viscus perforation by peritoneal catheter, although perforation of the small bowel, stomach, and other hollow viscus has also been reported. [13456] Majority of the cases of bowel perforation and nonenteric hollow viscus perforation by the peritoneal catheter of VPS occurred in children, and most of them presented with extrusion of the peritoneal catheter from the natural orifices. [1345]…”

Section: Discussionmentioning

confidence: 99%

“…[123] Colon is the most common site for hollow viscus perforation by the peritoneal catheter, but perforation of the small bowel, stomach, and other hollow viscus has also been reported. [1345] Disconnection of VPS catheter is also a well-known complication and is observed more in multicomponent shunt systems. [67] This present case is a report of VPS catheter disconnection, downward shunt migration, and silent bowel perforation by peritoneal catheter occurred in a child at the same time.…”

Section: Introductionmentioning

confidence: 99%

Ventriculoperitoneal Shunt Disconnection, Shunt Migration, and Silent Bowel Perforation in a 10-Year-Old Boy

Ghritlaharey

2019

Journal of Neurosciences in Rural Practice

Self Cite

View full text Add to dashboard Cite

A 10-year-old boy was admitted with chest wall infection around the implanted ventriculoperitoneal shunt (VPS) catheter of 5 days. He had received a right-sided, medium pressure, whole-length VPS for hydrocephalus, following tubercular meningitis at the age of 3 years. Seven years, 9 months following VPS implantation, he was admitted with shunt tract infection at the chest area for 5 days. He had neither fever nor features of meningitis, raised intracranial pressure, or peritonitis. His clinical examination and radiological investigations revealed that the VPS catheter was disconnected at the cranial site, and it was migrated downward up to the upper chest. He was managed well with the removal of the entire VPS catheter. The removed peritoneal catheter along with the shunt chamber was loaded with fecal matter and was presumed that the peritoneal catheter was within the colon. His postoperative recovery was excellent. This is a rare case of VPS catheter disconnection, shunt migration, and silent bowel perforation by peritoneal catheter, and all the above-mentioned complications were detected in a child at the same time and were managed well with the removal of the entire VPS catheter.

show abstract

Review of the Management of Peroral Extrusion of Ventriculoperitoneal Shunt Catheter

Cited by 12 publications

References 34 publications

The Conundrum of Ventricular Dilatations Following Decompressive Craniectomy: Is Ventriculoperitoneal Shunt, The Only Panacea?

The Conundrum of Ventricular Dilatations Following Decompressive Craniectomy: Is Ventriculoperitoneal Shunt, The Only Panacea?

Upward migration and peroral extrusion of a peritoneal shunt catheter: Case report and review of the literature

Ventriculoperitoneal Shunt Disconnection, Shunt Migration, and Silent Bowel Perforation in a 10-Year-Old Boy

Contact Info

Product

Resources

About