The incidence of inguinal complications after ventriculoperitoneal shunt for hydrocephalus

Abstract

The younger the age at which the VP shunt was performed, the higher the incidence of CIM. Bilateral manifestations were higher than in the normal population. Increased intra-abdominal pressure by accumulation of fluid in combination with the high patency rate of processus vaginalis possibly plays a role in the development of CIM in VP shunt patients. Bilateral repair should be considered even when CIM is unilateral. Special care should be given to repair procedures since the recurrence rate is relatively high.

Hydrocele of the Canal of Nuck as a Result of a Rare Ventriculoperitoneal Shunt Complication

“…Clarnette et al [9] reported 15% of children developing inguinal hernia and 6% of boys developing hydrocele in 430 VP-shunt-inserted pediatric patients. Celik et al [1] also reported 21 cases (23.8%) with CIM after VP shunt insertion composed of 19 boys and only 2 girls. According to the reported cases in the literature, it is clear that CIM of VP shunt procedures are very rare in females.…”

“…Alternatively raised pressure may convert a patent processus vaginalis from a potential to a clinical hernia. It is also reported that the incidence of patency of the processus vaginalis is higher in the first 6 months of life and intra-abdominal fluid accumulation in this period increases the risk of inguinoscrotal hernias and hydroceles [1, 9]. Our case was also admitted to our clinic when she was 5 months old.…”

“…Therefore children with ventriculoatrial shunts have a much lower incidence of inguinal hernia than those with VP shunts [1, 3, 9, 10]. …”

“…The ventriculoperitoneal (VP) shunt is widely used for the treatment of hydrocephalus and diverse complications related with this procedure have been reported in 24–74% of patients [1,2,3,4,5,6,7,8]. Among these, clinical inguinal manifestations (CIM) such as hernia, hydrocele, acute scrotum, testicular torsion or migration of the catheter into the scrotum are rare entities and mostly seen in male infants [1, 3,5,6,7,9,10,11,12,13,14].…”

“…Among these, clinical inguinal manifestations (CIM) such as hernia, hydrocele, acute scrotum, testicular torsion or migration of the catheter into the scrotum are rare entities and mostly seen in male infants [1, 3,5,6,7,9,10,11,12,13,14]. Peritoneal catheter migration into some anatomical and patent congenital cavities and increased intra-abdominal pressure are the main causes of CIM after VP application [1, 9]. In girls, a small evagination of parietal peritoneum accompanies the round ligament through the inguinal ring into the inguinal canal which is called the canal of Nuck and which is homologous to the processus vaginalis in the male and undergoes complete obliteration at the end of the first year.…”