Shunt Revision to Ventriculoatrial Shunt Due to Long-Term Abdominal Distension Complicated by Neonatal Necrotizing Enterocolitis and Cerebrospinal Fluid Overproduction after Ventriculoperitoneal Shunt for the Management of Post-Hemorrhagic Hydrocephalus: A Case Report

Abstract

A cerebrospinal fluid (CSF) shunt is the most common treatment known to date in the treatment of hydrocephalus. A ventriculoperitoneal (VP) shunt is one of the most commonly favored procedures for CSF diversion. We present a case of shunt revision from a VP shunt to a ventriculoatrial (VA) shunt. The patient was diagnosed with germinal matrix hemorrhage with intraventricular hemorrhage shortly after birth with a history of ileostomy surgery for neonatal necrotizing enterocolitis 10 days after birth. The patient began to develop hydrocephalus around 7 weeks after birth and she had VP shunt surgery at 6 months old for post-hemorrhagic hydrocephalus. After the VP shunt surgery, the patient experienced several months of vomiting and constipation along with worsening of the abdominal distension. Distal abdominal catheter externalization was temporarily performed, and 20 to 30 mL/kg of CSF was drained daily. Abdominal distension was still not resolved after 2 weeks and VA shunting was performed. The patient was discharged with improved abdominal distension and was followed for 3 years without any complications. We report a relatively rare case of a shunt revision to VA shunt due to long-term abdominal distension complicated by neonatal necrotizing enterocolitis and CSF overproduction after VP shunting.

The “peel-away” technique for a ventriculoatrial shunt in a 6-month-old patient: A case report

“…In our presented case, the risk of infection and contamination of the peritoneal catheter was associated with the need for the patient to undergo surgical intervention in the abdominal cavity for a liver transplant due to bile duct atresia. While a VPS is not an absolute contraindication in liver transplant patients, it is preferable to opt for other types of shunts to mitigate potential complications[ 5 , 11 ] that could impact the liver transplant.…”

Abdominal pseudocyst complicating ventriculoperitoneal shunt: A rare indication for ventriculopleural shunt conversion

“…Various radiographic modalities such as plain X-ray, USG, and CT scan of the abdomen are preferred to rule out other causes of acute abdomen and help determine the continuity of the shunt. 21 USG is a method of choice in the evaluation of the APC and other complications at the distal end of the VP shunt. 12 USG is preferred over CT scan in children due to less radiation exposure and its cost-effectiveness.…”