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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
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Pleural effusion in a child with a ventriculoperitoneal shunt and congenital heart disease

Jennifer Henningfeld1, Rohit S Loomba2, Santiago Encalada1

  • 1Department of Pulmonary and Sleep Medicine, Children's Hospital of Wisconsin/Medical College of Wisconsin, 9000 W. Wisconsin Ave MS B620, Milwaukee, WI 53226 USA.

Springerplus
|February 6, 2016
PubMed

Insights

This case study details an infant with congenital heart disease who developed a cerebrospinal fluid (CSF) leak into the chest cavity. The condition required complex surgical interventions, including ventriculoatrial shunt placement.

Area of Science:

  • Pediatric Cardiology
  • Neurosurgery
  • Thoracic Surgery

Background:

  • Infants with congenital heart disease may require complex interventions like extracorporeal membrane oxygenation (ECMO).
  • Complications such as intraventricular hemorrhage and hydrocephalus can necessitate cerebrospinal fluid (CSF) management.

Purpose of the Study:

  • To report a unique case of CSF extravasation into the thoracic cavity in an infant with congenital heart disease.
  • To highlight the diagnostic challenges and management strategies for CSF pleural effusion secondary to ventriculoperitoneal shunt malfunction.

Main Methods:

  • Case presentation of an 8-month-old infant with a history of tetralogy of Fallot repair and hydrocephalus.
  • Diagnostic workup including imaging to identify the source of pleural effusion.
  • Surgical interventions including diaphragmatic repair and ventriculoperitoneal (VP) shunt conversion to ventriculoatrial (VA) shunt.

Main Results:

  • The infant developed a large right-sided pleural effusion confirmed as CSF accumulation.
  • CSF extravasation occurred secondary to poor peritoneal absorption and a diaphragmatic defect.
  • Successful management involved diaphragm repair and conversion to a VA shunt due to persistent ascites.

Conclusions:

  • Cerebrospinal fluid extravasation should be considered in the differential diagnosis of pleural effusions in pediatric patients with VP shunts.
  • Ventriculoatrial shunt placement is a viable option in complex cases of CSF management in children with congenital heart disease.
  • This case underscores the importance of multidisciplinary collaboration in managing rare complications in pediatric cardiac surgery patients.

Keywords:
Congenital heart diseaseEffusionShuntVentriculoatrialVentriculoperitoneal

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