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Cerebrospinal fluid ascites: a complication of a ventriculoperitoneal shunt
Insights
A congenital omphalocele case developed E. coli infection and hydrocephalus, requiring shunts. Post-immunization, CSF ascites emerged, resolved by a ventriculoatrial shunt, highlighting complex pediatric surgical case management.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Infectious Diseases
Background:
- A one-year-old male presented with congenital anomalies including omphalocele, malrotation, and Ladd's bands.
- The patient experienced an E. coli wound infection leading to meningitis-ventriculitis, successfully treated with antibiotics.
Purpose of the Study:
- To describe a complex case of a pediatric patient with multiple congenital anomalies and subsequent infections.
- To illustrate the management of hydrocephalus and cerebrospinal fluid (CSF) ascites in a neonate.
Main Methods:
- Initial management involved antibiotic therapy for infection and a ventriculoperitoneal shunt for hydrocephalus.
- Subsequent development of CSF ascites post-immunization prompted the placement of a ventriculoatrial shunt.
Main Results:
- The E. coli infection and meningitis-ventriculitis resolved with antibiotic treatment.
- Obstructive hydrocephalus was initially managed with a ventriculoperitoneal shunt.
- Post-immunization CSF ascites resolved after conversion to a ventriculoatrial shunt.
Conclusions:
- This case highlights the intricate surgical and medical management required for neonates with complex congenital anomalies and associated complications.
- The successful resolution of CSF ascites with a ventriculoatrial shunt underscores its utility in specific pediatric neurosurgical scenarios.
Abstract:
A 1 year old Caucasian male born with an omphalocoele, malrotation of the large bowel, and Ladd's bands developed an E. coli wound infection and subsequent meningitis-ventriculitis which responded to antibiotic therapy. Aqueductal stenosis and obstructive hydrocephalus initially was treated with a ventriculoperitoneal shunt. After a routine diphtheria-pertussis-tetanus immunization, the child developed a CSF ascites which resolved following a ventriculoatrial shunt.