[Acute abdominal complications of ventriculoperitoneal shunts]

A review of critical abdominal complications is made in 150 patients operated on for hydrocephalus in the surgical and neurosurgical services of the Hospital Infantil Legaria through the years 1975--1976. We found 3 colonic perforations (cecum, transverse and rectum), one abdominal perforation, one through the umbilicus, one in vagina, 1 case of plastic peritonitis and two with ascitis. In the majority of cases, such complications were satisfactorily solved; sometimes by extraction of the derivative systems, and some others by primary closure of the lesions. We only had one death. In a larger percentage, other complications were observed, being in order of frequency the following: distal catheter obstruction, proximal obstruction, infection and abdominal wall cysts. We analysed the association with spina bifida (meningocele o myelomeningocele), frequency related to age, sex, etiology and type of shunt. We reviewed the literature and suggest general measures tending to avoid such complications.