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Case report of symptomatic cholelithiasis after ventricular cholecystic shunt
Gregory A Surfield1, Robert L Klein
1Department of Surgery, Summa Health System, Akron, OH 44309, USA. surfield@hotmail.com <surfield@hotmail.com>
Insights
A rare complication of ventricular cholecystic shunts, cholelithiasis encrusted on tubing, occurred 11 years post-insertion. Surgical revision resolved symptoms, demonstrating shunt revision effectiveness for late-stage complications.
Area of Science:
- Pediatric Neurosurgery
- Gastrointestinal Surgery
Background:
- Hydrocephalus management frequently involves cerebrospinal fluid shunts.
- Ventriculo-peritoneal shunts are common, but ventricular cholecystic shunts offer an alternative when needed.
- Late complications of shunts require careful consideration for patient management.
Observation:
- A case report details a patient with a ventricular cholecystic shunt experiencing a late complication.
- Eleven years after shunt placement, the patient presented with cholelithiasis (gallstones) encrusted on the shunt tubing.
- This finding represents a unique and delayed adverse event associated with this type of shunt.
Findings:
- The primary finding was the significant encrustation of gallstones on the ventricular cholecystic shunt tubing.
- Following shunt revision surgery, the patient experienced symptom relief.
- Post-revision follow-up showed no recurrence of cholelithiasis after six months.
Implications:
- This case highlights a potential, albeit rare, long-term complication of ventricular cholecystic shunts.
- It underscores the importance of considering shunt integrity and potential encrustation in long-term follow-up.
- Shunt revision can be an effective treatment for such late-onset complications, restoring patient well-being.
Abstract:
Hydrocephalus is a prevalent problem in the pediatric population, and patients with ventriculo-peritoneal shunts are often encountered. The use of ventricular cholecystic shunts is an option for patients who are unable to have a ventriculo-peritoneal shunt. This is a case report that describes a late complication of a ventricular cholecystic shunt. Eleven years after insertion of a ventricular cholecystic shunt, the patient developed cholelithiasis encrusted on shunt tubing. The shunt was revised, and 6 months follow-up has shown relief of symptoms and no further evidence of cholelithiasis.
