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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
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Appendicitis and Peritonitis in Children with a Ventriculo-Peritoneal Shunt

Glenn M C Fröschle1, Johanna Hagens1, Philip Mannweiler2

  • 1Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.

Children (Basel, Switzerland)
|March 29, 2023
PubMed

Insights

Appendicitis in pediatric patients with ventriculoperitoneal shunts (VPS) requires aggressive surgical management, including shunt exteriorization and reimplantation. Prompt intervention is crucial for favorable outcomes in these complex cases.

Area of Science:

  • Pediatric Surgery
  • Neurosurgery
  • Gastroenterology

Background:

  • Ventriculoperitoneal shunts (VPS) are common in pediatric patients for hydrocephalus management.
  • Abdominal symptoms in VPS patients can mimic or complicate common surgical conditions like appendicitis.
  • Effective management strategies for appendicitis in VPS patients are critical.

Purpose of the Study:

  • To outline the management of pediatric patients with appendicitis and VPS.
  • To analyze diagnostic and operative approaches for this specific patient cohort.
  • To identify optimal treatment pathways and potential complications.

Main Methods:

  • Retrospective analysis of 17 pediatric patients with VPS and acute abdomen (2012-2022).
  • Patients categorized into appendicitis (Group A) and primary peritonitis (Group B).
  • Evaluation of diagnostics, surgical procedures, cultures, and antibiotic treatments.

Main Results:

  • Appendicitis patients (Group A) were younger, sicker, and had more neurological symptoms than Group B.
  • All appendicitis patients underwent VPS exteriorization, with reimplantation after 20 days.
  • No specific details on complications, cultures, or antibiotic regimens were provided for Group A.

Conclusions:

  • Aggressive surgical intervention is recommended for VPS patients presenting with acute abdomen.
  • Complete change of the shunt system is suggested for appendicitis cases.
  • Early consideration of shunt infection/dysfunction and prompt surgical care are vital.

Keywords:
appendicitischildrensurgical managementventriculoperitoneal shunt

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