Abdominal Complications of VP Shunt in Pediatric Patients

Abstract

Sarvagya Jain*, Shashi Shankar Sharma, Ram Mohan Shukla, K Lavanya, Hemant Thanna and Saksham Kumar

Purpose: Ventriculo Peritoneal shunt (VP shunt) is the one of the most common and remains the gold standard treatment for infants and adults with congenital or acquired hydrocephalus, such as that due to a tumor. Complications include infection, obstruction of the shunt itself, and failure of a valve, or over- and under drainage of a ventricle. Intra-abdominal complications of a VP shunt are rare. Here, we report 3 abdominal complications of VP shunt, 2 obstruction and 1 perforation.

Case report 1: 7 month male: operated case of hydrocephalus with VP shunt in situ presented with complaint of not passing motion and flatus since 3 days and abdominal distension since 2 days. X-ray showed multiple air fluid levels and Patient was explored, there were multiple adhesions in the bowel loops which were causing obstruction.

Case Report 2: 1 year male operated case of VP Shunt for hydrocephalus 1 year back c/o VP shunt coming out per rectally since 1 day and pain in abdomen.

O/e: VP shunt was coming out of anus and per abdominally patient was guarding X-ray showed: VP shunt was piercing colon and coming out from anus.

Case report 3: 4 months male not passing motion associated with abdominal distension since 2 days. Patient was operated for VP shunt 2 months back.

OE: Per abdomen was distended and PR was roomy and empty.

X-ray and suggestive of Intestinal obstruction. Patient was explored and it was found multiple adhesions in between the bowel loops.

Discussion and Conclusion: Although complications of a VP shunt are common, abdominal complications, especially intestinal obstruction and perforation are rare. Regardless of the cause, management of bowel obstruction is the same.