Management of Abdominal Complications of Ventriculoperitoneal and Thecoperitoneal Shunts

Abstract

Background: The overall incidence of hydrocephalus in the general population is not known since the condition occurs in association with a large number of childhood and adult intracranial diseases. It is obvious that the reported incidence of infantile hydrocephalus, namely 3 to 4 per 1000 live birth is grossly understated. Objective: The aim of this study was to study various complications of the ventriculoperitoneal shunt and their management. Patients and methods: This a prospective study, a total of assessed 20 patients of complicated shunt operations for hydrocephalus in single group, the age of the patients varied from two months to seventeen years?; there were ten males and ten female patients, at Al-Azhar University Hospitals between March 2017 and June 2018. Results: Treatment of shunt obstruction was done by shunt revision using a new catheter which was easy with excellent results in absence of infections. 65% of the cases with shunt infection occurred during the first six months after initial shunt insertion. Treatment of patients with shunt infection was done by shunt removal, CSF drainage and combined intravenous and intraventricular antibiotics according to culture and sensitivity. Shunt insertion was done after negative three successive CSF cultures and lower CSF protein level. The cure rate was 62.5% in cases of shunt infections using the above-mentioned regimen. Conclusion: The complication due to non-infective causes is easy to manage and usually requires a short stay of the patient in the hospital.