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Reversible ventriculoperitoneal shunt dysfunction and chronic constipation: case report.

Barbara A Morais, Daniel D Cardeal, Fernanda G Andrade

    Journal of Neurosurgery. Pediatrics
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    Summary
    This summary is machine-generated.

    Constipation can temporarily impair ventriculoperitoneal shunts (VPS), especially in children with neurogenic bowel. Promptly treating constipation can resolve VPS malfunction and prevent unnecessary surgeries.

    Keywords:
    VPS = ventriculoperitoneal shuntconstipationhydrocephalusmalfunctionmyelomeningoceleventriculoperitoneal shunt

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    Area of Science:

    • Pediatric Neurosurgery
    • Gastroenterology

    Background:

    • Hydrocephalus is common in patients with myelomeningocele or cerebral palsy, often necessitating ventriculoperitoneal shunt (VPS) placement.
    • Neurogenic bowel leading to constipation is a frequent comorbidity in these patients, increasing the risk of VPS dysfunction.

    Observation:

    • A 6-year-old girl with a VPS for hydrocephalus presented with symptoms suggestive of shunt malfunction, including headache, vomiting, and abdominal distension.
    • Abdominal radiography revealed significant bowel distension, correlating with the patient's constipation.

    Findings:

    • Conservative management of constipation, including enemas and digital maneuvers, led to symptom resolution and normalization of ventricular size on CT scan.
    • Constipation can cause transient VPS malfunction through increased intra-abdominal pressure and direct catheter obstruction by distended bowel loops.

    Implications:

    • Recognizing and treating constipation as a cause of VPS malfunction can prevent unnecessary surgical revisions in susceptible pediatric patients.
    • Careful monitoring is crucial, as some constipation treatments may inadvertently increase intracranial pressure.