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Ventriculoperitoneal shunt dysfunction and constipation: a chart review
C L Bragg1, J Edwards-Beckett, N Eckle
1Children's Hospital, Columbus, Ohio 43205.
Insights
Constipation is common in children with hydrocephalus and may cause ventriculoperitoneal (VP) shunt dysfunction. Bowel cleansing resolved shunt issues in some cases, suggesting a link between constipation and VP shunt problems.
Area of Science:
- Pediatric Neurosurgery
- Gastroenterology
Background:
- Children with hydrocephalus often develop chronic constipation.
- Ventriculoperitoneal (VP) shunts are common treatments for hydrocephalus.
Purpose of the Study:
- To investigate the potential role of constipation in ventriculoperitoneal (VP) shunt dysfunction in pediatric patients.
Main Methods:
- Retrospective chart review of 51 children treated for hydrocephalus.
- Analysis of documented constipation and VP shunt dysfunction symptoms.
- Evaluation of outcomes after bowel cleansing interventions.
Main Results:
- 19 out of 51 children reviewed had documented constipation.
- In 6 cases, bowel cleansing led to resolution of shunt dysfunction symptoms without surgical revision.
- Constipation was characterized by infrequent, difficult stools or colonic fullness.
Conclusions:
- Constipation may influence fluid or pressure dynamics within VP shunts.
- Constipation is a potential contributing factor to VP shunt dysfunction in children.
- Bowel management may be a relevant consideration in managing VP shunt issues.
Abstract:
Children treated for hydrocephalus frequently experience chronic constipation. A retrospective chart review was conducted to determine if there is a population of children with ventriculoperitoneal (VP) shunt dysfunction in whom constipation might be a factor in the shunt dysfunction. Of 51 cases reviewed, 19 had documented constipation, such as no bowel movement for 2 or more days, small hard ball-like stools or fullness of the colon noted on physical examination or abdominal radiographs. In 6 cases, a bowel cleansing was performed and signs and symptoms of shunt dysfunction resolved without shunt revision. This review suggests that constipation may affect the fluid or pressure dynamics of the VP shunt and contribute to shunt dysfunction.