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Intestinal obstruction caused by extraperitoneal cerebrospinal fluid collection
Naim-Ur-Rahman1, A Jamjoom, Z A Jamjoom
1Division of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Insights
A large cerebrospinal fluid collection from a ventriculoperitoneal shunt caused intestinal obstruction in a child. The "coiling sign" may indicate shunt misplacement, aiding diagnosis and prevention.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Radiology
Background:
- Hydrocephalus is often treated with a ventriculoperitoneal shunt.
- Complications can arise from shunt placement and fluid accumulation.
Observation:
- A 3-year-old child developed intestinal obstruction.
- The obstruction was caused by external compression from a massive extraperitoneal cerebrospinal fluid collection.
Findings:
- The cerebrospinal fluid collection was secondary to ventriculoperitoneal shunt malfunction.
- A specific radiological sign, the "coiling sign", was identified, indicating shunt misplacement at the peritoneal level.
Implications:
- Early recognition of the "coiling sign" can prevent shunt misplacement.
- Understanding radiological findings aids in managing and preventing shunt-related complications like intestinal obstruction.
Abstract:
External compression caused by a massive extraperitoneal cerebrospinal fluid collection lead to intestinal obstruction in a 3-year-old child who had previously had a ventriculoperitoneal shunt for treatment of hydrocephalus. Radiological findings and ways of preventing this situation are discussed. A useful diagnostic radiological sign, the "coiling sign', indicating shunt misplacement at the peritoneal level, is also described.