Intraabdominal Complications Secondary to Ventriculoperitoneal Shunts: CT Findings and Review of the Literature

Chung, Jae Joon; Yu, Jeong-Sik; Kim, Joo Hee; Nam, Se Jin; Kim, Do Young

doi:10.2214/ajr.09.2463

Cited by 119 publications

(106 citation statements)

References 29 publications

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“…The occurrence of an abdominal abscess following VPS placement is rare, accounting for only 5% of intra-abdominal shunt related complications in one retrospective study. 11 The organisms isolated from VPS related abdominal abscesses include pseudomonas, 2 staphylococci and enterococcus, 12 consistent with the most common organisms associated with VPS infections. Hepatic abscesses are the most commonly reported intra-abdominal location in the literature.…”

Section: Discussionmentioning

confidence: 91%

Intra-Abdominal Ventriculoperitoneal Shunt Abscess from Streptococcus Pyogenes after Pharyngitis with Scarlet Fever: Case Report and Review of the Literature

Chen

Monaco²

2014

Neuro Open J

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CitationChen SH, Monaco EA 3 rd . Intra-abdominal ventriculoperitoneal shunt abscess from Streptococcus pyogenes after pharyngitis with scarlet fever: Case report and review of the literature. Neuro Open J. 2014; 1(1): 27-30. doi: 10.17140/NOJ-1-107rd . This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. However, Streptococcus pyogenes (Group A Streptococcus, GAS) as a causative agent appears to be extremely rare. We present an unusual case of a peritoneal shunt infection due to GAS that occurred after pharyngitis with scarlet fever. Case Description: A 31 year-old woman with congenital shunt-dependent hydrocephalus presented with fever, vomiting, and acute abdominal symptoms several weeks after being treated for pharyngitis and scarlet fever. She was found to have a large intra-abdominal peritoneal catheter-associated abscess that grew out GAS. Results: The patient's shunt was externalized at the clavicle and the cerebrospinal fluid (CSF) was sterile. Her peritoneal abscess was treated by percutaneous drainage, laparotomy, and intravenous antibiotics. More permanent CSF diversion was accomplished via ventriculoatrial shunt creation after treatment. She made a full recovery. Conclusion: While shunt infection is an all too common clinical problem, this is the first report of a peritoneal shunt infection caused by GAS after pharyngitis and scarlet fever. Presumably, this infection occurred as a result of haematogenous spread to the shunt site in the abdomen.

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Section: Discussionmentioning

confidence: 91%

Intra-Abdominal Ventriculoperitoneal Shunt Abscess from Streptococcus Pyogenes after Pharyngitis with Scarlet Fever: Case Report and Review of the Literature

Chen

Monaco²

2014

Neuro Open J

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“…The differential diagnosis of acute abdomen in patients with VPS may encompass a wide spectrum of underlying diseases 4,6,10,11 . Patients with underlying chronic diseases such as MPS and myelomeningocele have higher complication rates than others with isolated hydrocephalus because of several associated risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…Several alternative procedures have been reported as a temporary or permanent solution to VPS failure, such as the Torkildsen procedure, ventriculopleural shunt, ventriculo-renal shunt, ventriculoureteral shunt, ventriculovenous shunt and ventriculosagittal shunt 4,10,13,14,15,16,17,18,19,20 .…”

Section: Discussionmentioning

confidence: 99%

“…The aforementioned procedures present a higher rate of complication when compared to VAS and all are considered third choice alternatives 7,8,9,10,11,12,13,14,15,16 . This is especially true in children under 8 year-old with restricted lung capacity, scoliosis or urinary system malformations 10 .…”

Section: Discussionmentioning

confidence: 99%

“…This is especially true in children under 8 year-old with restricted lung capacity, scoliosis or urinary system malformations 10 .…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic assisted ventriculoperitoneal shunt revisions as an option for pediatric patients with previous intraabdominal complications

Carvalho

Bellas

Guimarães

et al. 2014

Arq. Neuro-Psiquiatr.

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Multiple shunt failure is a challenge in pediatric neurosurgery practice and one of the most feared complications of hydrocephalus. Objective: To demonstrate that laparoscopic procedures for distal ventriculoperitoneal shunt failure may be an effective option for patients who underwent multiple revisions due to repetitive manipulation of the peritoneal cavity, abdominal pseudocyst, peritonitis or other situations leading to a "non reliable" peritoneum. Method: From March 2012 to February 2013, the authors reviewed retrospectively the charts of six patients born and followed up at our institution, which presented with previous intra-peritoneal complications and underwent ventriculoperitoneal shunt revision assisted by video laparoscopy. Results: After a mean follow-up period of nine months, all patients are well and no further shunt failure was identified so far. Conclusion: Laparoscopy assisted shunt revision in children may be, in selected cases, an effective option for patients with multiple peritoneal complications due to ventriculo-peritoneal shunting.Keywords: hydrocephalus, ventriculoperitoneal shunt, abdominal pseudocyst, laparoscopic surgery. RESUMOMúltiplas disfunções de derivações ventrículo-peritoneais em pacientes crônicos são complicações temidas no tratamento das hidrocefalias e um desafio na prática neurocirúrgica. Objetivo: Demonstrar que a abordagem laparoscópica para o tratamento das obstruções distais das derivações ventrículo-peritoneais é uma opção eficaz em pacientes submetidos a múltiplas revisões, manipulação repetitiva da cavidade abdominal, pseudocisto abdominal, peritonite ou outras complicações indutoras de peritônio "não confiável". Método: Os autores revisaram retrospectivamente, de março de 2012 a fevereiro de 2013, os prontuários de seis pacientes nascidos e acompanhados em um hospital pediátrico, que apresentaram múltiplas complicações intraperitoneais e tiveram a revisão de derivações ventrículo-peritoneais assistida por videolaparoscopia. Resultados: Todos os pacientes melhoraram clinicamente e nenhuma outra disfunção foi identificada após um período de acompanhamento médio de 9 meses. Conclusão: Revisão distal de derivações ventrículo-peritoneais assistida por videolaparoscopia em crianças é, em casos selecionados, uma opção eficaz para pacientes crônicos com história de múltiplas complicações peritoneais.Palavras-chave: hidrocefalia, derivação ventrículo-peritoneal, pseudocisto abdominal, cirurgia laparoscópica.Surgical treatment of hydrocephalus accounts for most of pediatric neurosurgical procedures and ventriculo-peritoneal shunting (VP shunt) remains the main option of treatment and also a major concern regarding complications 1,2,3 . Shunt complications, defined as obstruction, overdrainage, loculation or infection, sometimes demands difficult solutions with high surgical morbidity and mortality 1,2,3,4 .Abdominal complications of VP shunt are not rare and the main causes of distal catheter failure are related to extra peritoneal retraction of the catheter, incis...

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Bacterial translocation as a cause of ventriculoperitoneal shunt infection: A case report

Owusu-Adjei

Ogagan

Smith

et al. 2022

Clinical Case Reports

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Intraabdominal Complications Secondary to Ventriculoperitoneal Shunts: CT Findings and Review of the Literature

Abstract: On abdominopelvic CT, various intraabdominal complications secondary to ventriculoperitoneal shunt were shown, of which, shunt infection was the most common, followed by CSF pseudocyst, abscess, and infected fluid collection.

Cited by 119 publications

References 29 publications

Intra-Abdominal Ventriculoperitoneal Shunt Abscess from Streptococcus Pyogenes after Pharyngitis with Scarlet Fever: Case Report and Review of the Literature

Intra-Abdominal Ventriculoperitoneal Shunt Abscess from Streptococcus Pyogenes after Pharyngitis with Scarlet Fever: Case Report and Review of the Literature

Laparoscopic assisted ventriculoperitoneal shunt revisions as an option for pediatric patients with previous intraabdominal complications

Bacterial translocation as a cause of ventriculoperitoneal shunt infection: A case report

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