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shunt_obstruction

Shunt obstruction

The Shunt obstruction is caused by fibrosis and is usually located on the tip of the ventricular catheter (proximal obstruction) and/or peritoneal catheter (distal obstruction).

Yet, the most frequent complication is ventricular catheter obstruction.

Significantly greater cerebral regional tissue oxygenation (rSO2) changes occur for distal shunt malfunction versus proximal malfunction after shunt tap test, indicating its potential as an adjunct tool for detecting shunt malfunction type 1).

The intra-abdominal instillation of icodextrin, HA/CMC, and heparin, especially icodextrin, can decrease the rate of vp shunt dysfunction by preventing formation of intraperitoneal fibrosis in a rat model 2).


Implant infection and obstruction are major ventriculoperitoneal shunt complications in patients with post-haemorrhagic hydrocephalus.

2016

A 84-year-old woman was examined for an enlargement of an induration in the left breast. A ventriculoperitoneal shunt had been placed for postoperative normal pressure hydrocephalus of a cerebral hemorrhage, and it had penetrated the mass according to the computed tomography findings. Breast cancer was diagnosed after a close examination; however, close observation was selected because her family rejected treatment. She developed somnolence 7 months after the initial examination, and ventricular dilatation and expansion of the low-density region around the ventricle were noted on computed tomography, suggesting that the enlarged tumor had excluded the shunt and caused obstruction. The growth of breast carcinoma involving a shunt tube can be the cause of obstruction of a ventriculoperitoneal shunt. This findings suggest that a breast lesion should be evaluated at both pre- and postoperation 3).

1)
Abramo TJ, Zhou C, Estrada C, Meredith M, Miller R, Pearson M, Tulipan N, Williams A. Innovative Application of Cerebral rSO2 Monitoring During Shunt Tap in Pediatric Ventricular Malfunctioning Shunts. Pediatr Emerg Care. 2014 Jun 4. [Epub ahead of print] PubMed PMID: 24901951.
2)
Aydoseli A, Tahta A, Aras Y, Sabancı A, Keskin M, Balik E, Onder S, Sencer A, Izgi N. Use of Antifibrotics to Prevent Ventriculoperitoneal Shunt Complications Due to Intra-abdominal Fibrosis: Experimental Study in a Rat Model. J Neurol Surg A Cent Eur Neurosurg. 2015 Mar 26. [Epub ahead of print] PubMed PMID: 25811104.
3)
Kamei M, Kikuchi N, Ichimura H, Chujo M, Takahashi Y, Sugio K. A case of breast cancer involving a ventriculoperitoneal shunt. Surg Case Rep. 2016 Dec;2(1):8. doi: 10.1186/s40792-016-0136-7. Epub 2016 Feb 6. PubMed PMID: 26943684; PubMed Central PMCID: PMC4744600
shunt_obstruction.txt · Last modified: 2018/09/17 08:08 by administrador