Migration of the Distal Catheter of Ventriculoperitoneal Shunts in Pediatric Age Group: Case Series
Ventriculoperitoneal (VP) shunting is the most commonly performed procedure in the treatment of hydrocephalus. VP shunt migration can occur at different sites. The aim of the study was to present different sites of abnormal distal shunt location, pathophysiology, and the management in each situation...
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| Veröffentlicht in: | World neurosurgery 2018-11, Vol.119, p.e131-e137 |
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| creator | Ezzat, Ahmed A.M. Soliman, Mohamed A.R. Hasanain, Amr A. Thabit, Mohamed A. Elshitany, Hesham Kandel, Haitham Abdel-Bari, Sameh H. Ghoul, Ahmed M.F. Abdullah, Ahmed Alsawy, Mohamed F.M. Ghaleb, Ammar A. Al Menabbawy, Ahmed Marei, Ahmed A. El Razik, Bassante Abd Schroeder, Henry W.S. Marx, Sascha Zohdi, Ahmed El Refaee, Ehab |
| description | Ventriculoperitoneal (VP) shunting is the most commonly performed procedure in the treatment of hydrocephalus. VP shunt migration can occur at different sites. The aim of the study was to present different sites of abnormal distal shunt location, pathophysiology, and the management in each situation.
Between 2014 and 2017, all patients with hydrocephalus in the Department of Neurosurgery, Cairo University, were gathered prospectively. All pediatric patients below the age of 12 years with shunt migration of the distal end of the VP shunt were identified.
Of 1092 patients operated on by the VP shunt between 2014 and 2017, 15 presented with shunt dysfunction because of distal shunt migration (6 anal, 3 scrotal, 1 colon, 1 peroral, 1 upper lumbar extrusion, 1 paraspinal, 1 penile, and 1 umbilical). Especially upper lumbar extrusion and paraspinal shunt location are extremely rare. All the 15 patients were treated successfully with VP shunts and prospectively followed until they presented with complications on different occasions.
Peritoneal complications are among the most common causes of VP failure. We present a rare complication where the shunt migrates outside the peritoneal cavity elsewhere with ambiguous pathogenesis. Special considerations have to be appointed during the shunt revision surgeries of these cases.
•The aim of the study was to present different sites of abnormal distal shunt migration and the management in each situation.•Shunt migration occurred in 1.4% in the present series of 1092 prospectively collected pediatric patients with hydrocephalus.•Six anal, 3 scrotal, 1 colon, 1 peroral, 1 upper lumbar extrusion, 1 paraspinal, 1 penile, 1 umbilical.•Especially upper lumbar extrusion and paraspinal shunt migration are extremely rare.•We recommend distal end insertion of the VP shunt using a minilaparotomy or laparoscopic surgery. |
| doi_str_mv | 10.1016/j.wneu.2018.07.073 |
| format | Article |
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Between 2014 and 2017, all patients with hydrocephalus in the Department of Neurosurgery, Cairo University, were gathered prospectively. All pediatric patients below the age of 12 years with shunt migration of the distal end of the VP shunt were identified.
Of 1092 patients operated on by the VP shunt between 2014 and 2017, 15 presented with shunt dysfunction because of distal shunt migration (6 anal, 3 scrotal, 1 colon, 1 peroral, 1 upper lumbar extrusion, 1 paraspinal, 1 penile, and 1 umbilical). Especially upper lumbar extrusion and paraspinal shunt location are extremely rare. All the 15 patients were treated successfully with VP shunts and prospectively followed until they presented with complications on different occasions.
Peritoneal complications are among the most common causes of VP failure. We present a rare complication where the shunt migrates outside the peritoneal cavity elsewhere with ambiguous pathogenesis. Special considerations have to be appointed during the shunt revision surgeries of these cases.
•The aim of the study was to present different sites of abnormal distal shunt migration and the management in each situation.•Shunt migration occurred in 1.4% in the present series of 1092 prospectively collected pediatric patients with hydrocephalus.•Six anal, 3 scrotal, 1 colon, 1 peroral, 1 upper lumbar extrusion, 1 paraspinal, 1 penile, 1 umbilical.•Especially upper lumbar extrusion and paraspinal shunt migration are extremely rare.•We recommend distal end insertion of the VP shunt using a minilaparotomy or laparoscopic surgery.</description><identifier>ISSN: 1878-8750</identifier><identifier>EISSN: 1878-8769</identifier><identifier>DOI: 10.1016/j.wneu.2018.07.073</identifier><identifier>PMID: 30031953</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Bowel perforation ; Catheters - adverse effects ; Cerebrospinal fluid (CSF) ; Child, Preschool ; Distal end migration ; Foreign-Body Migration - etiology ; Humans ; Hydrocephalus ; Hydrocephalus - diagnostic imaging ; Hydrocephalus - surgery ; Infant ; Lumbar extrusion ; Male ; Peroral extrusion ; Postoperative Complications - etiology ; Predictive Value of Tests ; Retrospective Studies ; Ventriculoperitoneal shunt (VP) ; Ventriculoperitoneal Shunt - adverse effects</subject><ispartof>World neurosurgery, 2018-11, Vol.119, p.e131-e137</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-c4c3a40daafbfa3e6aeb22050f1bba29b6e097fa93611e866896c24ce8f48ea83</citedby><cites>FETCH-LOGICAL-c356t-c4c3a40daafbfa3e6aeb22050f1bba29b6e097fa93611e866896c24ce8f48ea83</cites><orcidid>0000-0001-8099-5041 ; 0000-0002-1808-7357 ; 0000-0003-1855-2551</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1878875018315511$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30031953$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ezzat, Ahmed A.M.</creatorcontrib><creatorcontrib>Soliman, Mohamed A.R.</creatorcontrib><creatorcontrib>Hasanain, Amr A.</creatorcontrib><creatorcontrib>Thabit, Mohamed A.</creatorcontrib><creatorcontrib>Elshitany, Hesham</creatorcontrib><creatorcontrib>Kandel, Haitham</creatorcontrib><creatorcontrib>Abdel-Bari, Sameh H.</creatorcontrib><creatorcontrib>Ghoul, Ahmed M.F.</creatorcontrib><creatorcontrib>Abdullah, Ahmed</creatorcontrib><creatorcontrib>Alsawy, Mohamed F.M.</creatorcontrib><creatorcontrib>Ghaleb, Ammar A.</creatorcontrib><creatorcontrib>Al Menabbawy, Ahmed</creatorcontrib><creatorcontrib>Marei, Ahmed A.</creatorcontrib><creatorcontrib>El Razik, Bassante Abd</creatorcontrib><creatorcontrib>Schroeder, Henry W.S.</creatorcontrib><creatorcontrib>Marx, Sascha</creatorcontrib><creatorcontrib>Zohdi, Ahmed</creatorcontrib><creatorcontrib>El Refaee, Ehab</creatorcontrib><title>Migration of the Distal Catheter of Ventriculoperitoneal Shunts in Pediatric Age Group: Case Series</title><title>World neurosurgery</title><addtitle>World Neurosurg</addtitle><description>Ventriculoperitoneal (VP) shunting is the most commonly performed procedure in the treatment of hydrocephalus. VP shunt migration can occur at different sites. The aim of the study was to present different sites of abnormal distal shunt location, pathophysiology, and the management in each situation.
Between 2014 and 2017, all patients with hydrocephalus in the Department of Neurosurgery, Cairo University, were gathered prospectively. All pediatric patients below the age of 12 years with shunt migration of the distal end of the VP shunt were identified.
Of 1092 patients operated on by the VP shunt between 2014 and 2017, 15 presented with shunt dysfunction because of distal shunt migration (6 anal, 3 scrotal, 1 colon, 1 peroral, 1 upper lumbar extrusion, 1 paraspinal, 1 penile, and 1 umbilical). Especially upper lumbar extrusion and paraspinal shunt location are extremely rare. All the 15 patients were treated successfully with VP shunts and prospectively followed until they presented with complications on different occasions.
Peritoneal complications are among the most common causes of VP failure. We present a rare complication where the shunt migrates outside the peritoneal cavity elsewhere with ambiguous pathogenesis. Special considerations have to be appointed during the shunt revision surgeries of these cases.
•The aim of the study was to present different sites of abnormal distal shunt migration and the management in each situation.•Shunt migration occurred in 1.4% in the present series of 1092 prospectively collected pediatric patients with hydrocephalus.•Six anal, 3 scrotal, 1 colon, 1 peroral, 1 upper lumbar extrusion, 1 paraspinal, 1 penile, 1 umbilical.•Especially upper lumbar extrusion and paraspinal shunt migration are extremely rare.•We recommend distal end insertion of the VP shunt using a minilaparotomy or laparoscopic surgery.</description><subject>Bowel perforation</subject><subject>Catheters - adverse effects</subject><subject>Cerebrospinal fluid (CSF)</subject><subject>Child, Preschool</subject><subject>Distal end migration</subject><subject>Foreign-Body Migration - etiology</subject><subject>Humans</subject><subject>Hydrocephalus</subject><subject>Hydrocephalus - diagnostic imaging</subject><subject>Hydrocephalus - surgery</subject><subject>Infant</subject><subject>Lumbar extrusion</subject><subject>Male</subject><subject>Peroral extrusion</subject><subject>Postoperative Complications - etiology</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Ventriculoperitoneal shunt (VP)</subject><subject>Ventriculoperitoneal Shunt - adverse effects</subject><issn>1878-8750</issn><issn>1878-8769</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9LAzEQxYMoWqpfwIPk6KU1f7ZJVryUqlVQFKpeQzad1ZTtpiZZxW9vlqpHw0Bmht97MA-hY0rGlFBxthp_ttCNGaFqTGQuvoMGVEk1UlKUu3_9hBygoxhXJD9OCyX5PjrgfV9O-ADZe_caTHK-xb7G6Q3wpYvJNHhm8pAg9OsXaFNwtmv8BoJLvoUMLN66NkXsWvwIS2d6AE9fAc-D7zbnWR8BLzIO8RDt1aaJcPTzD9Hz9dXT7GZ09zC_nU3vRpZPRBrZwnJTkKUxdVUbDsJAxRiZkJpWlWFlJYCUsjYlF5SCEkKVwrLCgqoLBUbxITrd-m6Cf-8gJr120ULTmBZ8FzUjsqCMMykzyraoDT7GALXeBLc24UtTovt89Ur3-eo-X01kLp5FJz_-XbWG5Z_kN80MXGwByFd-OAg6WgetzfkEsEkvvfvP_xvjpYz8</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Ezzat, Ahmed A.M.</creator><creator>Soliman, Mohamed A.R.</creator><creator>Hasanain, Amr A.</creator><creator>Thabit, Mohamed A.</creator><creator>Elshitany, Hesham</creator><creator>Kandel, Haitham</creator><creator>Abdel-Bari, Sameh H.</creator><creator>Ghoul, Ahmed M.F.</creator><creator>Abdullah, Ahmed</creator><creator>Alsawy, Mohamed F.M.</creator><creator>Ghaleb, Ammar A.</creator><creator>Al Menabbawy, Ahmed</creator><creator>Marei, Ahmed A.</creator><creator>El Razik, Bassante Abd</creator><creator>Schroeder, Henry W.S.</creator><creator>Marx, Sascha</creator><creator>Zohdi, Ahmed</creator><creator>El Refaee, Ehab</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8099-5041</orcidid><orcidid>https://orcid.org/0000-0002-1808-7357</orcidid><orcidid>https://orcid.org/0000-0003-1855-2551</orcidid></search><sort><creationdate>201811</creationdate><title>Migration of the Distal Catheter of Ventriculoperitoneal Shunts in Pediatric Age Group: Case Series</title><author>Ezzat, Ahmed A.M. ; 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VP shunt migration can occur at different sites. The aim of the study was to present different sites of abnormal distal shunt location, pathophysiology, and the management in each situation.
Between 2014 and 2017, all patients with hydrocephalus in the Department of Neurosurgery, Cairo University, were gathered prospectively. All pediatric patients below the age of 12 years with shunt migration of the distal end of the VP shunt were identified.
Of 1092 patients operated on by the VP shunt between 2014 and 2017, 15 presented with shunt dysfunction because of distal shunt migration (6 anal, 3 scrotal, 1 colon, 1 peroral, 1 upper lumbar extrusion, 1 paraspinal, 1 penile, and 1 umbilical). Especially upper lumbar extrusion and paraspinal shunt location are extremely rare. All the 15 patients were treated successfully with VP shunts and prospectively followed until they presented with complications on different occasions.
Peritoneal complications are among the most common causes of VP failure. We present a rare complication where the shunt migrates outside the peritoneal cavity elsewhere with ambiguous pathogenesis. Special considerations have to be appointed during the shunt revision surgeries of these cases.
•The aim of the study was to present different sites of abnormal distal shunt migration and the management in each situation.•Shunt migration occurred in 1.4% in the present series of 1092 prospectively collected pediatric patients with hydrocephalus.•Six anal, 3 scrotal, 1 colon, 1 peroral, 1 upper lumbar extrusion, 1 paraspinal, 1 penile, 1 umbilical.•Especially upper lumbar extrusion and paraspinal shunt migration are extremely rare.•We recommend distal end insertion of the VP shunt using a minilaparotomy or laparoscopic surgery.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30031953</pmid><doi>10.1016/j.wneu.2018.07.073</doi><orcidid>https://orcid.org/0000-0001-8099-5041</orcidid><orcidid>https://orcid.org/0000-0002-1808-7357</orcidid><orcidid>https://orcid.org/0000-0003-1855-2551</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | World neurosurgery, 2018-11, Vol.119, p.e131-e137 |
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| language | eng |
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| subjects | Bowel perforation Catheters - adverse effects Cerebrospinal fluid (CSF) Child, Preschool Distal end migration Foreign-Body Migration - etiology Humans Hydrocephalus Hydrocephalus - diagnostic imaging Hydrocephalus - surgery Infant Lumbar extrusion Male Peroral extrusion Postoperative Complications - etiology Predictive Value of Tests Retrospective Studies Ventriculoperitoneal shunt (VP) Ventriculoperitoneal Shunt - adverse effects |
| title | Migration of the Distal Catheter of Ventriculoperitoneal Shunts in Pediatric Age Group: Case Series |
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