Neurological Surgery No Shinkei Geka Volume 26, Issue 11 (November 1998)

Rare Intra-abdominal Complications of a Ventriculoperitoneal Shunt : report of three cases Kunio YAMAMURA 1 , Osamu KODAMA 1 , Hiroshi KAJIKAWA 1 , Masahiro KAWANISHI 1 , Akira SUGIE 1 , Minako KAJIKAWA 1 , Shogo FUJII 2 , Shinya SUMIOKA 2 1Section of Neurosurgery, Suiseikai Kajikawa Hospital 2Department of Neurosurgery, Osaka Medical College Keyword: ventriculoperitoneal shunt , normal pressure hydrocephalus , intraabdominal complication pp.1007-1011
Published Date 1998/11/10
  • Abstract
  • Look Inside

Three cases of rare intra-abdominal complications of ventriculoperitoneal shunt (VPS) surgery are re-ported. Case 1 was a 32-year-old male who had undergone VPS surgery for hydrocephalus following meningitis on July 10, 1980. Two weeks later he developed fever and a cystic mass about 10cm in diameter in the right hypochondrium. Shuntography and a barium enema study demonstrated a pseudocyst at the distal end of the shunt. The cyst wall was excised, the peritoneal tube removed, and VPS converted to a ventriculoatrial route following which the pseudocyst resolved. Case 2 was a 49-year-old female who de-veloped hydrocephalus following subarachnoid hemorrhage, and VPS surgery was performed on March 10, 1989. Two weeks later, she developed fever and right upper abdominal pain. Abdominal x-ray and CT scan revealed a right subdiaphragmatic abscess. The abscess was drained and the shunt system was re-moved on April 4. VPS was placed again on April 21 without further complications. She was symptom free for the next 7 years. Case 3 was a 57-year-old female who presented in a semicomatous state after fall-ing from bed on May 5, 1995. CT scan showed left-sided acute subdural hematoma (ASDH) for which sur-gery was performed. Her neurological status improved postoperatlvely. She eventually developed hydroce-phalus and left-sided subdural effusion for which right VPS and left subduroperitoneal shunt (SPS) sur-gery was performed on January 25, 1996. The peritoneal end of the tube of the SPS protruded out of the anus one and a half year after shunt piacement, The entire SPS system was removed as there was no more collection in the subdural space.

We reviewed the literature and discussed the pathophysiology involved in the development of intra-abdominal complications following VPS.

Copyright © 1998, Igaku-Shoin Ltd. All rights reserved.


Neurological Surgery 脳神経外科
26巻11号 (1998年11月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院