Management of Postoperative Ventriculoperitoneal Shunt Complications in Pediatric Patients

Abstract

Background: Postoperative ventriculoperitoneal (VP) shunt complications in pediatric patients involves impaired absorption of CSF from the subarachnoid space to the venous circulation via the arachnoid villi. It also involves obstruction in flow of CSF from the ventricles to the subarachnoid space. Objective: To assess the proper management of postoperative shunt complications. Patients and Methods: Retrospective study conducted in the Neurosurgery Department of Al-Azhar University Hospitals and El-Sahel Teaching Hospital. Pediatric patients from both genders including infants and pediatric patients till 12 years old who were having postoperative ventriculoperitoneal shunt complications were assessed clinically and radiographically for the best management that include either surgical or medical ones or both .Results: The management of postoperative VP shunt malfunction is essential shunt revision of either proximal or distal catheters or the whole system if shunt disintegration is suspected. The most common organisms in shunt infection were gram positive organisms (coagulase negative staph. and staph. aureus). Conclusion: The most effective management plan is shunt revision. To prevent VP shunt malfunction, we have to make sure of intraoperative closed, sterile and functioning shunt system.