The wandering ventriculoperitoneal shunt and the scope of its salvage
- 8 May 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Child's Nervous System
- Vol. 37 (8), 2613-2618
- https://doi.org/10.1007/s00381-021-05198-5
Abstract
Purpose Distal shunt tube migration following ventriculoperitoneal (VP) shunt placement in children is mostly managed by an initial shunt diversion/removal and subsequent replacement. Lately, shunt salvage is being used as an alternative in certain conditions. We have focused on the situations where one can consider or disregard shunt salvage in such cases. Method A retrospective study of children treated for distal shunt migration following VP shunt placement between January 2013 and December 2019. Result Seventeen children were managed for over 7 years. These included cutaneous extrusions (n = 4), hollow viscus perforation (n = 6), inguinal hernias (n = 5), and umbilical extrusion (n = 2). The surgical treatment varied from a cutaneous wound closure (with a tube in situ), temporary external shunt diversion, and laparotomy with shunt reposition into the peritoneal cavity. Shunt salvage was possible in three cases, whereas in 2 cases even though shunt salvage was possible, it was not feasible due to a short residual shunt length. Conclusion VP shunt salvage is possible in certain cases of distal shunt migration with a functional uninfected shunt. Small cutaneous extrusions can be covered by a local skin flap. Also, one should consider the residual intraperitoneal shunt length before its salvage in small children.This publication has 19 references indexed in Scilit:
- Subpericranial shunt valve placement: a technique in patients with friable skinChild's Nervous System, 2014
- Length of peritoneal end of shunt catheters in hydrocephalus in children and rate of complicationsJournal of Cranio-Maxillary Diseases, 2012
- Ventriculoperitoneal shunt complications needing shunt revision in children: A review of 5 years of experience with 48 revisionsAfrican Journal of Paediatric Surgery, 2012
- Management of skin erosion following deep brain stimulationNeurosurgical Review, 2008
- Unusual Ventriculoperitoneal Shunt Extrusion: Experience with 5 Cases and Review of the LiteraturePediatric Neurosurgery, 2007
- Long-term Air-exposed Functioning Hydrocephalus Valve with No InfectionSouthern Medical Journal, 2006
- Nonfunctional abdominal complications of the distal catheter on the treatment of hydrocephalus: an inflammatory hypothesis?Child's Nervous System, 2006
- Extrusion of peritoneal catheter through the mouthChild's Nervous System, 1996
- Time-related patterns of ventricular shunt failureChild's Nervous System, 1994
- Ventriculoperitoneal shunt procedure complicated by ureter obstructionJournal of Neurosurgery, 1983