scholarly journals A rare case of ventriculoperitoneal shunt knot causing intestinal obstruction in an adult

2019 ◽  
Vol 6 (2) ◽  
pp. 640
Author(s):  
Mayank Bhasin ◽  
Karamjot Singh Bedi ◽  
Tarun Chaudhary ◽  
Gurvansh S. Sachdeva ◽  
Shantanu Kumar Sahu
Keyword(s):  
Intestinal Obstruction ◽  
Ventriculoperitoneal Shunt ◽  
Rare Complication ◽  
Exploratory Laparotomy ◽  
Vp Shunt ◽  
Primary Surgery ◽  
First Case ◽  
Ventriculoperitoneal Shunting ◽  
History Of ◽  
Low Incidence

Despite high incidence of complications, Ventriculoperitoneal shunting for hydrocephalus is the cornerstone and the most common neurosurgical procedure. Ventriculoperitoneal shunt knot causing intestinal obstruction is an extremely rare complication needing surgical intervention. A 19 years old male with history of VP shunting in infancy for hydrocephalus with no history of any revision surgery presented in emergency with pain abdomen and multiple episodes of vomiting for 2 days. X ray showed dilated bowel loops with a coiled up VP shunt in the abdomen. Exploratory laparotomy showed multiple dilated bowel loops with a loop of VP shunt around ileal segment with dense fibrotic adhesions causing obstruction. Extensive adhesiolysis was done. Procedure underwent uneventful. Patient recovered swiftly in postoperative period and is currently asymptomatic after 6 months of surgery. Improved surgery skills and shunt design have prevented much of the morbidity of VP shunting. Most of the cases reported earlier were paediatric patients with history of repetitive handling of catheter. We believe this to be the first case of intestinal obstruction by a VPS knot in an adult with no history of manipulation after primary surgery. Due to low incidence it is difficult to clinically suspect such an extremely rare complication. Therefore, an awareness of VP shunt related complications in adult is essential.

scholarly journals Abdominal Pseudocyst: A Rare Complication of Ventriculoperitoneal Shunting

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Faisal ◽  
Ridha Dharmajaya ◽  
Ihsan Tala ◽  
Abdurrahman Mousa ◽  
Steven Tandean
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Rare Complication ◽  
Shunt Malfunction ◽  
Vp Shunt ◽  
Shunt Placement ◽  
Ventriculoperitoneal Shunting ◽  
Abdominal Pseudocyst

Abstract. Ventriculoperitoneal (VP) shunt placement is one of the most commonly performed procedures in neurosurgery. One rare complication is the formation of an abdominal pseudocyst, which can cause shunt malfunction. Keyword: Abdominal Pseudocyst, Ventriculoperitoneal Shunt

scholarly journals Anal Extrusion of Ventriculoperitoneal Shunt: A Case Report and Review of Literature

2021 ◽  
Vol 31 (4) ◽  
pp. 13
Author(s):  
Farhad Bal'afif ◽  
Donny Wisny Wardhana ◽  
Tommy Alfandy Nazwar ◽  
Novia Ayuning Nastiti
Keyword(s):  
Physical Examination ◽  
Ventriculoperitoneal Shunt ◽  
Surgical Procedure ◽  
Rare Complication ◽  
Female Child ◽  
Contributing Factors ◽  
Peritoneal Catheter ◽  
Factors Affecting ◽  
Vp Shunt ◽  
Life Threatening

<p>Ventriculoperitoneal (VP) Shunt is a commonly performed surgical procedure and offers a good result in the treatment of hydrocephalus. In general, 25% of the complication rate of this surgical procedure is abdominal complications. Anal extrusion of a peritoneal catheter is a rare complication ranging from 0.1 to 0.7% of all shunt surgeries. This study presents a rare case of anal extrusion of ventriculoperitoneal shunt in a 1-year-old female child who was asymptomatic. The physical examination revealed swelling and redness along the shunt tract on the retro auricular region, soft abdomen, and no catheter was observed in the anal. This study found several contributing factors affecting the complications in the anal extrusion of a peritoneal catheter, that are thin bowel wall in children and sharp tip and stiff end of VP shunt. The shunt should be disconnected from the abdominal wall, and the lower end should be removed through the rectum by colonoscopy or sigmoidoscopy/proctoscopy or by applying gentle traction on the protruding tube. This study concludes that due to potentially life-threatening consequences and case rarity, thorough anamnesis, physical examination, and objective investigation are needed to determine the appropriate management for anal extrusion of ventriculoperitoneal shunt. </p>

Intestinal volvulus secondary to a ventriculoperitoneal shunt

1971 ◽  
Vol 35 (1) ◽  
pp. 95-96 ◽  
Author(s):  
Thomas H. Sakoda ◽  
John A. Maxwell ◽  
Charles E. Brackett
Keyword(s):  
Intestinal Obstruction ◽  
Ventriculoperitoneal Shunt ◽  
Unusual Complication ◽  
Content Type ◽  
Intestinal Volvulus ◽  
Silastic Catheter ◽  
Ventriculoperitoneal Shunting ◽  
Catheter Implantation ◽  
Fine Print

✓ Volvulus with intestinal obstruction is an unusual complication of ventriculoperitoneal shunting. It was the most serious of the few complications experienced in 56 cases of intraperitoneal Silastic catheter implantation and probably represented reaction to the peritoneal incision rather than reaction of the tissue to Silastic.

Sterile cerebrospinal fluid ascites, hydrothorax and hydrocele as a complication of ventriculoperitoneal shunting in an elderly patient

2021 ◽  
Vol 14 (7) ◽  
pp. e242593
Author(s):  
Xiancheng Wu ◽  
Michael Sandhu ◽  
Rajat Dhand ◽  
Leen Alkukhun ◽  
Jivan Lamichhane
Keyword(s):  
Elderly Patient ◽  
Cerebrospinal Fluid ◽  
Normal Pressure ◽  
Age Group ◽  
Massive Ascites ◽  
Diagnostic Modality ◽  
Vp Shunt ◽  
Ventriculoperitoneal Shunting ◽  
History Of ◽  
Scrotal Swelling

An 89-year-old man with a history of multiple abdominal surgeries and ventriculoperitoneal (VP) shunt placement for normal pressure hydrocephalus presented for intractable abdominal bloating and scrotal swelling, for which imaging revealed massive ascites, bilateral hydrocele and small bilateral pleural effusions. Cardiac, hepatic and renal workup were insignificant. Culture and cytology of ascitic fluid were negative for infection or malignancy. Aetiology of the ascites as secondary to Cerebrospinal fluid (CSF) from the VP shunt was confirmed via ligation of the shunt. Sterile CSF ascites, hydrothorax and hydrocele are rare complications of VP shunt for hydrocephalus and are mostly presented in paediatric patients. We report the first known case of concurrent CSF ascites, hydrothorax and hydrocele in an elderly patient. We examine the difficulty of shunt replacement as a diagnostic and treatment modality in this age group and propose the use of reversible shunt ligation as a diagnostic modality.

scholarly journals Rectal adenocarcinoma with rectoprostatic fistula following prostate brachytherapy

2019 ◽  
Vol 12 (3) ◽  
pp. e226151
Author(s):  
Basil Francis Moss ◽  
Amjad M Peracha
Keyword(s):  
Prostate Cancer ◽  
Rare Complication ◽  
Rectal Adenocarcinoma ◽  
Second Primary ◽  
Prostate Brachytherapy ◽  
Suprapubic Catheter ◽  
Second Primary Cancers ◽  
First Case ◽  
History Of ◽  
Radiation Induced

An 80-year-old man with history of prostate cancer successfully treated with brachytherapy was initially thought to have Fournier’s gangrene until imaging detected a rectoprostatic fistula. Although this is known to be a rare complication of prostate brachytherapy, in this case the aetiology was a new primary rectal adenocarcinoma. It was not possible to catheterise per urethra owing to the fistula, so he was fitted with suprapubic catheter, and underwent palliative loop colostomy. Brachytherapy carries a low risk of second primary cancers, although two previous cases reported such cancers as radiation induced. This is, to our knowledge, the first case of rectal adenocarcinoma following prostate brachytherapy in the literature.

scholarly journals Primary ileal volvulus: a rare cause of small intestinal obstruction

2020 ◽  
Vol 7 (4) ◽  
pp. 1304
Author(s):  
Syed Faizan ◽  
Amit Kumar C. Jain ◽  
Durganna Thimmappa
Keyword(s):  
Intestinal Obstruction ◽  
Iliac Fossa ◽  
Significant Risk ◽  
Exploratory Laparotomy ◽  
Small Bowel Volvulus ◽  
The Past ◽  
Risk Of Mortality ◽  
History Of ◽  
Abdominal Examination ◽  
Small Intestinal

A 50-year-old lady presented to us in the emergency department with history of acute abdominal pain and vomiting since the past 24 hours. Abdominal examination showed tenderness and guarding in the hypogastrium, lumbar and right iliac fossa region. Initial diagnosis of ruptured appendicitis was considered but exploratory laparotomy gave us an intra-operative surprise. Small bowel volvulus is extremely rare in clinical practice and their symptoms are usually nonspecific. The diagnosis is typically confirmed at surgery most of the time just like in this case. No etiology of this volvulus was found in this patient. Ileal volvulus carries a significant risk of mortality. Awareness of this condition among surgeons will help to reduce the morbidity and mortality associated with this unusual form of intestinal obstruction.

scholarly journals A STUDY OF INTESTINAL OBSTRUCTION CONSERVTIVE VERSUS SURGICAL MANAGEMENT

2020 ◽  
Vol 1 (2) ◽  
pp. 10-16
Author(s):  
MA Oyinlola ◽  
OA Omisakin
Keyword(s):  
Abdominal Surgery ◽  
Intestinal Obstruction ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Exploratory Laparotomy ◽  
Related Factors ◽  
Previous Abdominal Surgery ◽  
Intestinal Contents ◽  
History Of ◽  
Obstructed Hernia

Intestinal obstruction refers to the impairment to the abnormal passage of intestinal contents which can be due to the mechanical obstruction or failure of normal intestinal motility in the absence of an obstructing lesion. Extra luminal, intrinsic, and intraluminal are three categories of small bowel obstruction. In this retrospective observational study, patients presenting to the A&E department of surgery unit who had similar condition were screened. The study is based on total of 60 patients out of which 22 patients managed conservatively whereas 38 patients were managed surgically. Common symptoms were abdominal pain and vomiting. 20 patients had previous abdominal surgery; 16 had exploratory laparotomy for abdominal trauma, perforation, gynae procedure, etc. 4 patients developed characteristic of obstruction following laproscopic. 14 patients undergone surgery while 6 patients were managed conservatively. Surgically managed duration was 2.8 days on average. Mean duration for conservatively managed patients was 2.9 days. Among the surgically managed patients, 11 had strictures, 14 had adhesion, 8 had obstructed hernia, 1 had intussusception, and 4 had abdominal TB. Based on the cause of the obstruction, surgical procedure was carried out. History of abdominal surgery was found to be more frequent in whom obstruction was relieved conservatively. The conclusion of the study is that adhesions based on previously conducted surgery are important causes of SBO. Two common method of managing the condition is conservative management and surgical management. The criteria for utilizing particular method is based on several patient related factors. Clinical decisions guide the management of SBO and timing of surgical intervention.

scholarly journals Emergency presentation of retrograde intussusception as a late complication of gastric bypass

2012 ◽  
Vol 94 (3) ◽  
pp. e116-e117 ◽  
Author(s):  
R Pande ◽  
I Fraser ◽  
C Harmston
Keyword(s):  
Gastric Bypass ◽  
Rare Complication ◽  
Late Complication ◽  
Emergency Presentation ◽  
Retrograde Intussusception ◽  
First Case ◽  
History Of ◽  
The Uk

Retrograde intussusception is a rare complication of a Roux-en-Y gastric bypass. With the rising number of gastric bypass operations being performed in the UK, the incidence of retrograde intussusception is likely to increase. We report the first case in the UK and highlight its insidious presentation and the importance of considering intussusception in any patient with a history of a Roux-en-Y gastric bypass.

scholarly journals Uncommon complications of ventriculoperitoneal shunt surgery: review of four cases and literature review

2020 ◽  
Vol 35 (1) ◽  
Author(s):  
Aliyu Muhammad Koko ◽  
Nasiru Jinjiri Ismail ◽  
Ali Lasseini ◽  
Sahabi M. Saddiku
Keyword(s):  
Cerebrospinal Fluid ◽  
Ventriculoperitoneal Shunt ◽  
Abdominal Wound ◽  
Distal Catheter ◽  
Excellent Outcome ◽  
Post Surgery ◽  
First Case ◽  
Ventriculoperitoneal Shunting ◽  
Shunt Procedure

Abstract Background Ventriculoperitoneal shunt is one of the most popular cerebrospinal fluid diversion procedures worldwide. Complications are common, but uncommon complications are rarely reported in the literature making a standardized guideline on management of unusual complications unavailable. We report this series of uncommon complications managed in our centre to share our experience and contribute to the pool of literature on the management of these weird complications of ventriculoperitoneal shunting. Case presentation The first case was a 10-year-old girl who presented with headache, early morning vomiting and itching over the tract of the shunt in the neck. She has had ventriculoperitoneal shunt and excision and repair of encephalocele at the age of 3 months in our facility. On physical examination, she was conscious with a Glasgow coma score of 15, and shunt valve was hardened. She had removal of the shunt with intraoperative finding of calcified shunt tubing and the valve, and also cerebrospinal fluid was under high pressure that warranted re-insertion of another medium pressure shunt. She remained stable at last follow-up 3 months post-surgery. We managed two cases of shunt extrusion via the anus (a 1-year-old female infant and 9-year-old boy). None of the patients presented with evidence of peritonitis or shunt tract infection. The extruded shunts were removed under aseptic technique, and both patients had ventriculoperitoneal shunt re-inserted because of progression of hydrocephalus. They remained stable at last follow-up visits 6 months after surgery. The fourth case was a 9-month-old infant that presented with shunt extrusion via the abdominal wound site 3 weeks after ventriculoperitoneal shunt procedure. The child developed an abscess at the abdominal wound that ruptures spontaneously with extrusion of distal catheter, had no features of peritonitis and had shunt removed and re-inserted after 3 months. The child has remained stable. Conclusion Although ventriculoperitoneal shunt calcification and extrusion are rare, they do occur. None of our patients had peritonitis. Shunt removal and subsequent reinsertion in the presence of raised intracranial pressure from hydrocephalus confirms an excellent outcome.

scholarly journals Phytobezoar causing intestinal obstruction in a neonate: A case report

2020 ◽  
Vol 10 ◽  
pp. 3
Author(s):  
Ravi Patcharu ◽  
Karunesh Chand ◽  
Badal Parikh
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Skill ◽  
Exploratory Laparotomy ◽  
History Taking ◽  
Case Presentation ◽  
Detailed History ◽  
Radiological Features ◽  
Common Etiology ◽  
History Of ◽  
Vegetative Matter

Background: Phytobezoars are concretions of non-digestible vegetative matter in the gastroin­testinal tract and are a rare cause of intestinal obstruction in children. Case presentation: We report a case of intestinal obstruction in a 2-day-old neonate with no specific radiological features pointing to any common etiology. On exploratory laparotomy, a swollen raisin was found impacted in the ileum causing intestinal obstruction. The history taken in retrospect revealed that the elder sibling had witnessed her father perform a traditional ritual of putting a drop of honey into the mouth of the newborn and she imitated the same with a raisin, which led to the obstruction. Conclusion: A careful detailed history of local traditional rituals is at times, the most important pointer towards the etiology of a clinical condition. The basic clinical skill of history taking is still very important, despite the availability of advanced radiological investigations.

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