scholarly journals Protrusion of ventriculoperitoneal shunt catheter tip through anus with silence abdomen

2021 ◽  
Author(s):  
See Liang Lim ◽  
Mohd Shahrulsalam Mohd Shah ◽  
Norsuhana Omar
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Clinical Symptoms ◽  
Simple Procedure ◽  
Bowel Perforation ◽  
Male Infant ◽  
Distal Portion ◽  
Communicating Hydrocephalus ◽  
Abdominal Incision ◽  
Abdominal Complication ◽  
Shunt Procedure

Introduction: Ventriculoperitoneal shunt (VPS) is most commonly performed surgical treatment for hydrocephalus by draining excessive cerebrospinal fluid (CSF) in ventricles to peritoneal cavity. Despite significant improvement in shunt procedure and being a relatively simple procedure, shunt complications remain common. Aim: The aim of this paper is to report a case of perforated bowel presented with silence abdomen following VPS insertion. Case study: We report a case of protrusion of distal VPS catheter through anus with silent abdomen, managed successfully with minimal intervention. Patient, 11-months-old male infant, diagnosed with congenital communicating hydrocephalus and VPS placement was done at 6 months of life, presented with tip of VPS protruding from anus after 4 months of VPS insertion. Patient was scheduled for removal of VPS, where shunt was disconnected through superficial abdominal incision, distal portion removed through anus without resistance. Postoperative patient recovers well without abdominal complication. Results and discussion: Perforation of bowel by distal peritoneal catheter is rare and only accounts for 0.1%–0.7% of complication. The exact pathogenesis for spontaneous bowel perforation is unclear. Management of bowel perforation secondary to VPS is highly individualized, mainly depending on its clinical symptoms and signs. Conclusions: Although bowel perforation following VPS insertion is rare, it carries high mortality up to 15% especially if unrecognized and delayed in treatment. Early detection and appropriate management are key in reducing VPS related morbidity and mortality.

scholarly journals PEDT-06 THERAPEUTIC STRATEGY FOR DISSEMINATED PILOCYTIC ASTROCYTOMAS

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii16-ii17
Author(s):  
Tomonari Suzuki ◽  
Rena Mizuno ◽  
Eita Uchida ◽  
Mitsuaki Shirahata ◽  
Junichi Adachi ◽  
...  
Keyword(s):  
Pilocytic Astrocytoma ◽  
Clinical Symptoms ◽  
Communicating Hydrocephalus ◽  
Protein Levels ◽  
Shunt Procedure ◽  
Elevated Protein ◽  
Pilocytic Astrocytomas ◽  
Female Case ◽  
The Common

Abstract BACKGROUND Pilocytic astrocytoma is one of the common tumors found during childhood. However, the clinical course of disseminated pilocytic astrocytoma is not clearly known. Here, we present two cases with disseminated pilocytic astrocytoma and discuss the treatment strategy. Patients We treated a 7-year-old female (case 1) and 9-year-old male (case 2) with hypothalamic pilocytic astrocytomas. The results of magnetic resonance imaging showed diffuse spinal dissemination at diagnosis. Chemotherapy with vincristine and carboplatin was administered as the firstline therapy. The tumors showed some shrinkage, and symptoms improved. During chemotherapy, the patients developed allergies to carboplatin. Therefore, we changed the chemotherapy treatment to vincristine. Other adverse events were not observed. In Case 1, we observed an intratumoral hemorrhage and hydrocephalus due to occlusion of the foramen Monro. Endoscopic surgery was performed, and no clinical deficit was observed. Case 2 underwent ventricular peritoneal shunt procedure for communicating hydrocephalus and a reoperation for shunt malfunction because of dense cerebrospinal fluid with elevated protein levels. The patients have not undergone radiotherapy until now. They had no severe clinical symptoms and went to school for 5 and 10 years, respectively, after the diagnoses. CONCLUSION Chemotherapy for disseminated pilocytic astrocytoma is effective and may help in avoiding radiotherapy. Chemotherapy should be administered before radiotherapy, considering long-term complications.

Spontaneous bowel perforation after ventriculoperitoneal shunt surgery: case report and a review of 45 cases

2000 ◽  
Vol 54 (5) ◽  
pp. 388-396 ◽  
Author(s):  
Satish Sathyanarayana ◽  
Esther L Wylen ◽  
Mustafa K Baskaya ◽  
Anil Nanda
Keyword(s):  
Case Report ◽  
Ventriculoperitoneal Shunt ◽  
Bowel Perforation ◽  
Shunt Surgery

scholarly journals A study on Complications of ventriculoperitoneal shunt surgery in Bir Hospital, Kathmandu, Nepal

2012 ◽  
Vol 1 (2) ◽  
pp. 119-122 ◽  
Author(s):  
BG Karmacharya ◽  
P Kumar
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Shunt Infection ◽  
Shunt Surgery ◽  
Inclusion Criteria ◽  
Medical Sciences ◽  
Referral Centre ◽  
Neurosurgical Procedure ◽  
Ventriculoperitoneal Shunts ◽  
Shunt Procedure ◽  
A Prospective Study

Background: Ventriculoperitoneal shunt is one of the most commonly performed neurosurgical procedure, both on the elective and emergency basis. However this procedure is dreaded because of complications. There is lack of prospective studies on complications of shunt procedure. In this study, the indications for shunt, the types used and complications of ventriculoperitoneal shunts were studied. Methods: This was a prospective study carried out in the national neurosurgical referral centre, Bir hospital, Kathmandu from April 2004 to March 2005. Results: There were 109 ventriculoperitoneal shunt procedures during the study period. Among them 60 consecutive patients who fulfilled the inclusion criteria were enrolled for the study. There were 43 male and 17 female patients, with age ranging from 4 months to 75 years. Fourteen patients (23.3%) developed complications which included shunt block, shunt infection, over drainage and shunt extrusion. Conclusion: About one fourth all patients who underwent ventriculoperitoneal shunt surgery developed complications. Shunt block and infections were the major complications. DOI: http://dx.doi.org/10.3126/njms.v1i2.6612 Nepal Journal of Medical Sciences. 2012;1(2): 119-22

scholarly journals Relationship of the Location of the Ventricular Catheter Tip and Function of the Ventriculoperitoneal Shunt

2019 ◽  
Vol 9 (1) ◽  
pp. 16-21
Author(s):  
DM Arman ◽  
Sheikh Muhammad Ekramullah ◽  
Sudipta Kumer Mukherjee ◽  
Joynul Islam ◽  
Mirza Hafizur Rashid ◽  
...  
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Significant Proportion ◽  
Catheter Placement ◽  
Ventricular Catheter ◽  
Shunt Procedure ◽  
Freehand Technique ◽  
Catheter Tip ◽  
And Function ◽  
Relationship Of ◽  
The Relationship

Object: The objective of this study was to determine the relationship of the location of the ventricular catheter tip and function of the ventriculoperitoneal shunt. Methods: This prospective observational study included 140 patients from a single institution who underwent a ventriculoperitoneal shunt procedure in which a new ventricular catheter was placed between September, 2013 and September 2016. Data abstracted for each patient included age, sex, diagnosis, site and side of ventricular catheter placement. Postoperative CT scan images were reviewed for accuracy of ventricular catheter placement. Patients were followed up over 2 ½ to 4 ½ years.63 patients were available for follow up. We lost communication with rest of the patients. The relationship of the location of the ventricular catheter tip and function of the ventriculoperitoneal shunt was analyzed in 63 patients. Results: There were 140 patients included in the study; accuracy ventricular catheter tip placement were 55 (39.28%) using freehand technique. VP shunt functioned well in 43 (68.25%) of 63 patients. Among the 43 patients with well functioning shunt ,19 were in accurate group ,7 were in suboptimal group and 17 were in inaccurate group.26 patients (41.27%) had good outcome with normal development and normal IQ Conclusions: Mechanical malfunction and infection are the most significant problems associated with shunts for the treatment of hydrocephalus. Above all, a significant proportion of shunt failure was due to obstruction of the ventricular catheter, and accurate placement of the shunt catheter is highly important to reduce the incidence of shunt malfunction. Bang. J Neurosurgery 2019; 9(1): 16-21

scholarly journals Cranioplasty as the treatment for contralateral subdural effusion secondary to decompressive craniectomy: a case report and review of the relevant literature

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096689
Author(s):  
Hao Wang ◽  
Fumei Chen ◽  
Liang Wen ◽  
Yuanrun Zhu ◽  
Zuobing Chen ◽  
...  
Keyword(s):  
Case Report ◽  
Decompressive Craniectomy ◽  
Clinical Course ◽  
Relevant Literature ◽  
Favourable Outcome ◽  
Communicating Hydrocephalus ◽  
Subdural Effusion ◽  
Current Case ◽  
Shunt Procedure ◽  
Alternative Treatment Option

Subdural effusion (SDE) is a common complication secondary to decompressive craniectomy (DC). This current case report describes a patient with contralateral SDE with a typical clinical course. Initially, he made a good recovery following a head trauma that caused a loss of consciousness and was treated with decompressive craniectomy. However, he only achieved temporary relief after each percutaneous fluid aspiration from an Ommaya reservoir implanted into the cavity of the SDE. He was eventually transferred to the authors’ hospital where he underwent cranioplasty, which finally lead to the reduction and disappearance of his contralateral SDE. Unexpectedly, his clinical condition deteriorated again 2 weeks after the cranioplasty with symptoms of an uncontrolled bladder. A subsequent CT scan found the apparent expansion of the whole cerebral ventricular system, indicating symptomatic communicating hydrocephalus. He then underwent a ventriculoperitoneal shunt procedure, which resulted in a favourable outcome and he was discharged 2 weeks later. A review of the current literature identified only 14 cases of contralateral SDE that were cured by cranioplasty alone. The mechanism of contralateral SDE has been widely discussed. Although the exact mechanism of contralateral SDE and why cranioplasty is effective remain unclear, cranioplasty could be an alternative treatment option for contralateral SDE.

Operative Related Infection Rates for Ventriculoperitoneal Shunt Procedures in a Children's Hospital

1987 ◽  
Vol 8 (2) ◽  
pp. 67-70 ◽  
Author(s):  
Janara J. Younger ◽  
James C.H. Simmons ◽  
Fred F. Barrett
Keyword(s):  
Cerebrospinal Fluid ◽  
Ventriculoperitoneal Shunt ◽  
Shunt Infection ◽  
Infection Risk ◽  
Csf Shunt ◽  
Infection Rates ◽  
Surgical Infection ◽  
Shunt Procedure ◽  
Csf Shunt Infection

AbstractWe determined the operative related cerebrospinal fluid (CSF) shunt infection rates for our institution over a 3-year period (1982 to 1984) using strictly defined numerator and denominator data. The minimum post-operative follow-up period was 12 months. The average surgical infection risk for a CSF shunt procedure at our institution during the study period was 13.3%. Annual infection rates were relatively constant (13.8%, 13.2% and 12.9%), however both quarterly (5.7% to 23.3%) and surgeon-specific (5.7% to 22.8%) rates varied widely. Infection rates calculated by using “traditional” numerator and denominator data were considerably lower (6.5% to 9.2%).Operative related CSF shunt infection rates should be determined by utilizing strictly defined numerator and denominator values in order to allow valid comparisons of published rates.

scholarly journals Five Predictors Affecting the Prognosis of Patients with Severe Odontogenic Infections

2020 ◽  
Vol 17 (23) ◽  
pp. 8917
Author(s):  
Nathalie Pham Dang ◽  
Candice Delbet-Dupas ◽  
Aurélien Mulliez ◽  
Laurent Devoize ◽  
Radhouane Dallel ◽  
...  
Keyword(s):  
Intensive Care ◽  
Psychiatric Disorders ◽  
Clinical Symptoms ◽  
Simple Procedure ◽  
Odontogenic Infection ◽  
Conditional Inference ◽  
Penicillin Allergy ◽  
University Hospital ◽  
Mandibular Molar

Background: Dental cellulitis management is no longer a simple procedure, as more and more patients are needing long-time hospitalization, several surgeries and intensive care follow-up. This prospective study seeks to highlight criteria that can split patients with severe odontogenic infection into two groups: those with simple evolution and those for whom complex management is necessary. Methods: In this observational study, all patients considered with a severe odontogenic infection (which necessitated hospital admission, intravenous antibiotics and general anaesthesia) were enrolled between January 2004 and December 2014 from Clermont-Ferrand University Hospital (France). They were split into two groups: those who needed one surgical intervention with tooth extraction and collection drainage combined with probabilistic antibiotic to treat infection and those who need several surgeries, intensive care unit follow-up or tracheotomy to achieve healing. Results: 653 patients were included, of which 611 (94%) had one surgery, 42 (6%) had more than one surgery before healing. Penicillin allergy (p < 0.001), psychiatric disorders (p = 0.005), oropharyngeal oedema (p = 0.008), floor oedema (p = 0.004), fever (p = 0.04) and trismus (p = 0.018) on admission were the most relevant predictors of complex evolution. A conditional inference tree (CTREE) illustrated the association of prognostic factors and the need of multiple surgery. Conclusions: Besides clinical symptoms of severity, complications of severe odontogenic infection are predicted by measurables and objectives criteria as penicillin allergy, mandibular molar, C-reactive protein level, psychiatric disorders and alcohol abuse. Their specific association potentialize the risks. IRB number: CE-CIC-GREN-12-08.

Bowel perforation complicating ventriculoperitoneal shunt: Case report and review

2003 ◽  
Vol 58 (1) ◽  
pp. 144-148 ◽  
Author(s):  
Mahmoud M. Yousfi ◽  
Norman S. Jackson ◽  
Maher Abbas ◽  
Richard S. Zimmerman ◽  
David E. Fleischer
Keyword(s):  
Case Report ◽  
Ventriculoperitoneal Shunt ◽  
Bowel Perforation

Fungal Peritonitis

1980 ◽  
Vol 1 (1) ◽  
pp. 3-3
Keyword(s):  
Peritoneal Dialysis ◽  
Antifungal Agents ◽  
Clinical Symptoms ◽  
Bowel Perforation ◽  
Catheter Removal ◽  
Analgesic Nephropathy ◽  
Chronic Glomerulonephritis ◽  
Gram Stain ◽  
Polycystic Kidney ◽  
Fungal Peritonitis

R. Khanna, D.G. Oreopoulos, 8.1. Vas, W. McCready and N. Dombros (will be presented at the European Dialysis and Transplantation Association, Prague, June 1980) Ten patients with chronic renal failure on intermittent perito. neal dialysis (3) and CAPD (7) developed fungal peritonitis. Six were males and four females. Four had chronic glomerulonephritis, three had polycystic kidney disease and one each had chronic pyelonephritis, diabetes and analgesic nephropathy. Dialysate effluent was cloudy in all. Eight patients had clinical symptoms (abdominal pain, nausea and vomiting) and signs (abdominal tenderness with rebound and guarding and lowgrade fever). Initially, gram stain identified fungus in six of them, namely Candida (6), Fusarium (2), Mucor (1), Trichosporon (1). Nine patients were treated with continuous lavage with a dialysate containing appropriate antifungal agents (Amphotericin B, 5 mg/l, 5-Fluorocytosine 50 mg/l and Miconazole 10 mg/l) for a period of 2 to 15 days. Only two patients improved on this therapy. In six the dialysis catheter had to be removed before there was any clinical improvement. Indications for catheter removal were persistent positive effluent culture and clinical deterioration. Four patients returned to peritoneal dialysis (IPD 1, CAPD 3); four were transferred to hemodialysis. Two who had bowel perforation died. Fungal peritonitis is not infrequent in chronic peritoneal dia. lysis, especially in patients on CAPD. In most cases, clinical cure will require catheter removal and antifungal therapy. Following the infection, patients can he returned to peritoneal dialysis.

scholarly journals Hydrocele following placement of a ventriculoperitoneal shunt case report

1990 ◽  
Vol 48 (1) ◽  
pp. 113-115 ◽  
Author(s):  
José Sena Calvário ◽  
Eliseu Paolioli Neto
Keyword(s):  
Case Report ◽  
Ventriculoperitoneal Shunt ◽  
Shunt Procedure

The authors report the case of a two years old patient with hydrocele alter ventriculoperitoneal shunt procedure.

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