A B S T R A C TVentriculoperitoneal (VP) shunt is a common procedure performed in the management of hydrocephalus in children. The peritoneal end of the shunt can migrate in the peritoneal cavity and extrude through the mouth, umbilicus, anus, vagina or urethra after injuring the overlying structures. Timely removal is necessary to prevent transmission of infection. We are reporting a case in which there is extrusion of shunt per urethra.

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A bstract Background Deaths due to snakebites and serious adverse reactions to anti-snake venom (ASV) are both underreported in India. Serious adverse reactions to ASV are common, contributing significantly to mortality and morbidity. We conducted a study to determine the frequency of occurrence of severe adverse reactions to ASV in children and study the various risk factors and their outcomes. Patients and methods We carried out a retrospective record review of all children of snake envenomation admitted in our tertiary care teaching hospital, from January 2013 to December 2016. Children aged 0 to 12 years admitted for snake envenomation and who received ASV as part of their treatment were included. Details about their management, including ASV usage and any adverse effects noted, were collected on a standard data collection form. Results Sixty-eight children were enrolled. Hemotoxic (52.9%) envenomation was more common than neurotoxic (35.2%). Severe adverse reactions were present in 42.6%, hypotension in 38.2%, and bronchospasm in 4.4% of the children. The overall mortality rate was 16.1%, anaphylaxis to ASV contributing to 36.3% of them. Mortality was significantly higher in cases with severe adverse reactions ( p = 0.005). ASV reactions were also significantly different with different manufacturers. Conclusions There is a high frequency of occurrence of severe adverse reactions to ASV resulting in significant morbidity and mortality. How to cite this article Hooda R, Parameswaran N, Subramanian M. Serious Adverse Reactions to Anti-snake Venom in Children with Snake Envenomation: An Underappreciated Contributor to Snakebite Mortality? Indian J Crit Care Med 2021;25(6):720–723.

We are presenting our experience with childhood pelviureteric junction obstruction (PUJO) over 27 years, including the demographic characteristics, etiology, clinical features, and management. Ureteropelvic obstruction (PUJO) is the most common cause of congenital hydrocephalus diagnosed antenatally. It should be managed early after birth to preserve the renal function.