Ventriculoperitoneal shunt perforations of the gastrointestinal tract

Grace Muthoni Thiong'o1, Christopher Luzzio2, A Leland Albright1

  • 1Division of Neurosurgery, Department of Surgery, Kijabe Hospital, Kijabe, Kenya; and.

Insights

Chhabra shunts were linked to a higher rate of gastrointestinal (GI) perforations in children with ventriculoperitoneal (VP) shunts. This increased risk may be due to their higher frictional forces, not stiffness.

Area of Science:

  • Pediatric Neurosurgery
  • Medical Device Engineering

Background:

  • Ventriculoperitoneal (VP) shunts are crucial for treating hydrocephalus in children.
  • Shunt malfunction, including gastrointestinal (GI) perforation, is a serious complication.

Purpose of the Study:

  • To determine the incidence of VP shunt GI perforations in pediatric patients.
  • To identify specific shunt types associated with perforations.
  • To compare the mechanical properties (stiffness, friction) of perforating shunts with others.

Main Methods:

  • Retrospective review of 197 pediatric VP shunt malfunction cases.
  • Mechanical testing of shunt catheters for stiffness (compression, buckling, bending) and frictional force.

Main Results:

  • Six children experienced VP shunt GI perforations; all involved Chhabra shunts.
  • Chhabra catheters exhibited the least stiffness and highest frictional force compared to Medtronic and Codman catheters.
  • Perforations presented as anal/oral protrusion or subcutaneous abscesses.

Conclusions:

  • Chhabra shunts demonstrate a higher perforation rate than other tested shunt types.
  • The increased perforation risk appears correlated with higher catheter friction, not reduced stiffness.
  • Further investigation into Chhabra shunt design and material properties is warranted.

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