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ventriculoperitoneal_shunt_complication [2017/03/20 12:31]
administrador
ventriculoperitoneal_shunt_complication [2018/02/28 16:03] (current)
administrador [Ventriculoperitoneal shunt obstruction]
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 see [[Ventriculoperitoneal shunt obstruction]] see [[Ventriculoperitoneal shunt obstruction]]
  
-===Abdominal complications===+===== Abdominal complications ===== 
 +see [[Ventriculoperitoneal shunt abdominal complications]].
  
-Various complications of distal end of the ventriculoperitoneal (VP) shunt have been described in the literature. 
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-Abdominal complications are reported in 5–47% of VP shunt cases 
-((Chung J, Yu J, Joo HK, Se JN, Kim M. Intraabdominal complications secondary to ventriculoperitoneal shunts: CT findings and review of the literature. American Journal of Roentgenology. 2009;​193(5):​1311–1317.)) 
-((Murtagh FR, Quencer RM, Poole CA. Extracranial complications of cerebrospinal fluid shunt function in childhood hydrocephalus. American Journal of Roentgenology. 1980;​135(4):​763–766.)). 
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-Ascites 
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-[[Abdominal pseudocyst]] 
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-Hydrocele 
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-Shunt extrusion 
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-[[Shunt migration]] 
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-CSF leaks 
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-Viscous perforations 
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-Protrusion of the catheter from the anus 
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-Spontaneous knotting of the peritoneal catheter is a rare complication of the VP shunt  
-((Borcek AO, Civi S, Golen M, Emmez H, Baykaner MK. An unusual ventriculoperitoneal shunt complication:​ spontaneous knot formation. Turkish Neurosurgery. 2012;​22(2):​261–264.)). 
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-[[Peritoneal catheter knot formation]] ​ 
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-**Liver abscess** 
-Pyogenic liver abscess in Taiwan is most commonly due to Klebsiella pneumoniae infection in diabetic patients, and less frequently due to biliary tract infections. Liver abscess caused by ventriculoperitoneal (VP) shunt is very rare. We report a case of liver abscess caused by methicillin-resistant Staphylococcus aureus (MRSA), which developed as a complication of an infected VP shunt. A 53-year-old woman, who had shad a VP shunt implanted 3 months previously for hydrocephalus due to intracranial hemorrhage, presented with fever off and on, drowsiness and seizure attacks for 1 week. Computed tomography (CT) of the brain showed only mild right-sided hydrocephalus,​ and was negative for intracranial hemorrhage and intracranial mass. Analysis of cerebrospinal fluid showed significant pleocytosis and hypoglycorrhachia. CT scan of the abdomen disclosed a huge abscess in the right lobe of the liver. Cultures of both the cerebrospinal fluid and aspirated liver abscess isolated MRSA. The patient was treated with intraventricular and intravenous vancomycin, intravenous teicoplanin and oral rifampicin, followed by oral chloramphenicol and rifampicin. Percutaneous drainage of the liver abscess and externalization of the VP shunt were performed. The liver abscess had resolved almost completely on ultrasonography after 2 weeks of therapy. Liver abscess in patients with a VP shunt should be considered a possible abdominal complication of the VP shunt, and may be caused by unusual pathogens. Diagnosis requires CT scan and direct aspiration and culture of the liver abscess. Treatment requires management of both the liver abscess and the infected shunt 
-((Shen MC, Lee SS, Chen YS, Yen MY, Liu YC. Liver abscess caused by an infected ​ 
-ventriculoperitoneal shunt. J Formos Med Assoc. 2003 Feb;​102(2):​113-6. PubMed 
-PMID: 12709741. 
-)). 
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 ====Silicone allergy==== ====Silicone allergy====
 [[Ventriculoperitoneal shunt complication]]s have rarely been attributed to [[silicone]] allergy, with only a handful of cases reported in literature. The classic presentation of allergy to silicone ventriculoperitoneal shunt, i.e., abdominal pain with recurrent skin breakdown along the shunt tract, is nonspecific and difficult to distinguish clinically from other causes of shunt-related symptoms. It can be diagnosed by detection of antisilicone antibodies and is treated with removal of the shunt and replacement,​ if needed, with a polyurethane shunt system. ​ [[Ventriculoperitoneal shunt complication]]s have rarely been attributed to [[silicone]] allergy, with only a handful of cases reported in literature. The classic presentation of allergy to silicone ventriculoperitoneal shunt, i.e., abdominal pain with recurrent skin breakdown along the shunt tract, is nonspecific and difficult to distinguish clinically from other causes of shunt-related symptoms. It can be diagnosed by detection of antisilicone antibodies and is treated with removal of the shunt and replacement,​ if needed, with a polyurethane shunt system. ​
ventriculoperitoneal_shunt_complication.1490009494.txt.gz · Last modified: 2017/03/20 12:31 by administrador