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Appendicitis in children with a ventriculoperitoneal shunt
W Pumberger1, M Löbl, W Geissler
1Division of Pediatric Surgery, University of Vienna, Austria.
Pediatric Neurosurgery
|August 7, 1998
Summary
Children with ventriculoperitoneal shunts presenting with acute abdomen need careful diagnosis. Appendicitis is a key consideration, and prompt ultrasound aids in timely surgical intervention while preserving the shunt.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Gastroenterology
Background:
- Ventriculoperitoneal shunts are common in children but can complicate acute abdominal presentations.
- Differentiating shunt-related issues from primary abdominal pathology is crucial for effective management.
Purpose of the Study:
- To analyze the diagnostic challenges and outcomes of appendicitis in children with ventriculoperitoneal shunts.
- To evaluate the safety of maintaining ventriculoperitoneal shunts during abdominal surgery for appendicitis.
Main Methods:
- Retrospective analysis of medical records for 6 pediatric patients with ventriculoperitoneal shunts and appendicitis.
- Review of diagnostic methods including history, clinical examination, and abdominal ultrasound.
- Assessment of surgical management and postoperative complications.
Main Results:
- Appendicitis was successfully diagnosed and treated surgically in 6 children with ventriculoperitoneal shunts.
- Abdominal ultrasound proved valuable in diagnosis, enabling prompt surgical intervention.
- Shunts were generally maintained during surgery; one patient required conversion to a ventriculoatrial shunt due to a postoperative pseudocyst.
Conclusions:
- Primary intra-abdominal diseases like appendicitis in children with ventriculoperitoneal shunts require surgical treatment, with shunt preservation being feasible.
- Shunt infection necessitates conservative management and shunt removal, avoiding laparotomy.
- Accurate diagnosis relies on thorough history, clinical assessment, and especially abdominal ultrasound.