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[Acute abdominal complications of ventriculoperitoneal shunts]
Insights
This review of 150 hydrocephalus surgeries found abdominal complications like colonic perforations and catheter obstructions. Most cases were resolved successfully, with only one death, highlighting the need for preventative measures.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Gastroenterology
Context:
- Hydrocephalus management often involves surgical interventions with potential for complications.
- A significant number of patients undergoing shunt procedures experience abdominal issues.
- Understanding these complications is crucial for improving patient outcomes.
Purpose:
- To review and analyze critical abdominal complications in pediatric hydrocephalus patients.
- To identify the types, frequency, and management of these complications.
- To suggest preventative strategies based on literature review and case analysis.
Summary:
- A review of 150 hydrocephalus surgeries identified several abdominal complications, including 3 colonic perforations, 1 abdominal perforation, umbilical perforation, vaginal perforation, plastic peritonitis, and ascites.
- Distal catheter obstruction, proximal obstruction, infection, and abdominal wall cysts were also common.
- Most complications were managed successfully through device removal or lesion closure, with a single mortality.
Impact:
- This study underscores the importance of vigilance for abdominal complications post-hydrocephalus surgery.
- Findings can inform surgical techniques and post-operative care protocols to minimize risks.
- Recommendations for preventative measures aim to reduce morbidity and mortality associated with shunt procedures.
Abstract:
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.