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Patent Persistent Fibrous Tract in a Patient with Disconnected Lumboperitoneal Shunt

Rajan Kumar Sharma1,2, Kiyoshi Takagi3, Yasuhiro Yamada2

  • 1Department of Neurosurgery, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.

Asian Journal of Neurosurgery
|September 10, 2019
PubMed

Insights

Disconnection of lumboperitoneal (LP) shunts can lead to cerebrospinal fluid (CSF) leakage through fibrous sheaths. Evaluating asymptomatic patients with shuntography can confirm patency and prevent complications before shunt removal.

Area of Science:

  • Neurosurgery
  • Biomaterials Science

Background:

  • Lumboperitoneal (LP) shunts are used to treat cerebrospinal fluid (CSF) disorders.
  • Catheter disconnection is a known complication of LP shunts.
  • The patency of fibrous sheaths around disconnected shunts for CSF passage is not well-established.

Observation:

  • A connective tissue sheath forms around peritoneal shunt tubing as a biological response.
  • A case study of a young patient with a disconnected LP shunt revealed a patent persistent fibrous tract.
  • This tract potentially allowed for CSF passage despite shunt disconnection.

Findings:

  • The literature lacks definitive proof regarding CSF passage through disconnected LP shunt fibrous sheaths.
  • This case provides evidence supporting the possibility of CSF flow through such sheaths.
  • Asymptomatic shunt disconnection warrants further investigation into sheath patency.

Implications:

  • Shuntography may be a valuable diagnostic tool for asymptomatic patients with disconnected LP shunts.
  • Identifying a patent fibrous tract could influence decisions regarding shunt removal.
  • Preventing complications associated with shunt removal in such cases is crucial.

Keywords:
Malfunctionpatent persistent fibrous tractrare

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