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J Neurol Surg A Cent Eur Neurosurg 2013; 74(01): 064-067
DOI: 10.1055/s-0032-1313643
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Spontaneous Umbilical Cerebrospinal Fluid Fistula due to Transdermal Dislocation of the Ventriculoperitoneal Distal Shunt Ending – A Case Report[*]

K. Fleissig
1   Nordstadtkrankenhaus, Neurochirurgie, Hannover, Germany
,
J. Hattingen
2   Nordstadtkrankenhaus, Neuroradiologie, Hannover, Germany
,
L. Wilkens
3   Nordstadtkrankenhaus, Pathologie, Hannover, Germany
,
C. Förster
3   Nordstadtkrankenhaus, Pathologie, Hannover, Germany
,
M. R. Gaab
1   Nordstadtkrankenhaus, Neurochirurgie, Hannover, Germany
,
R. Burger
1   Nordstadtkrankenhaus, Neurochirurgie, Hannover, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
01 August 2012 (online)

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Spontaneous Umbilical Cerebrospinal Fluid Fistula due to Transdermal Dislocation of the Ventriculoperitoneal Distal Shunt Ending – A Case ReportCent Eur Neurosurg 2011; 72(S 01): e39-e39
DOI: 10.1055/s-0031-1286263

Introduction

Ventriculoperitoneal shunt (VPS) placement is the most common procedure in the treatment of non-obstructive hydrocephalus. The most serious complications of this treatment are disconnection, breaking, kinking and tip occlusion of the tube, shunt infection, intestinal obstruction, migration of the shunt catheter, and the perforation of internal organs.[1] [4] [9] [12] In addition, the literature illustrates a few extremely unusual complications,[4] [5] [9] [13] such as skin fistula in the thoracic or umbilical region. Thus, we report on a rare case of secondary transumbilical peritoneal shunt perforation after VPS placement in a patient with normal-pressure hydrocephalus.

* This article was originally published online in Central European Neurosurgery on January 16, 2012 (DOI:10.1055/s-0031-1286263)


 

  • References

  • 1 Agha FP, Amendola MA, Shirazi KK , et al. Unusual abdominal complications of ventriculoperitoneal shunts. Radiology 1983; 146: 323-326
    CrossrefPubMedGoogle Scholar
  • 2 Chen PR, Spetzler RF. Persistent lower abdominal pain induced by long peritoneal shunt catheter. Acta Neurochir (Wien) 2008; 150 (8) 829-831
    CrossrefPubMedGoogle Scholar
  • 3 Das PC, Radhakrishna K, Rao PLNG. Spontaneous umbilical fistula: a rare complication of ventrikuloperitoneal shunt. J Pediatr Surg 1993; 28 (4) 630-631
    CrossrefPubMedGoogle Scholar
  • 4 Dua R, Jain R. Peroral extrusion of ventriculoperitoneal shunt: a case report and review of the literature. Cen Eur Neurosurg 2011; 72 (2) 107-108
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Ghritlaharey RK, Budhwani KS, Shrivastava DK , et al. Trans-anal protrusion of ventriculo-peritoneal shunt catheter with silent bowel perforation: report of ten cases in children. Pediatr Surg Int 2007; 23 (6) 575-580
    CrossrefPubMedGoogle Scholar
  • 6 Goldblum RM, Pelley RP, ODonell AA , et al. Antibodies to silicone elastomers and reactions to ventriculoperitoneal shunts. Lancet 1992; 340 (8818) 510-513
    CrossrefPubMedGoogle Scholar
  • 7 Gower DJ, Lewis Jr JC, Kelly DL. Sterile shunt malfunction. A scanning electron microscopic perspective. J Neurosurg 1984; 61 (6) 1079-1084
    CrossrefPubMedGoogle Scholar
  • 8 Grosfeld JL, Cooney DR. Inguinal hernia after ventriculoperitoneal shunt for hydrocephalus. J Pediatr Surg 1974; 9: 311-315
    CrossrefPubMedGoogle Scholar
  • 9 Gupta A, Ahmad FU, Kumar A , et al. Umbilical CSF fistula: a rare complication of ventriculoperitoneal shunt. Acta Neurochir (Wien) 2006; 148: 1205-1207
    CrossrefPubMedGoogle Scholar
  • 10 Hussain NS, Wang PP, James C , et al. Distal ventriculoperitoneal shunt failure caused by silicone allergy. Case report. J Neurosurg 2005; 102 (3) 536-539
    CrossrefPubMedGoogle Scholar
  • 11 Matsuoka H, Takegami T, Maruyama D , et al. Transanal prolapse of a ventriculoperitoneal shunt catheter – case ceport. Neurol Med Chir (Tokyo) 2008; 48: 526-528
    CrossrefPubMedGoogle Scholar
  • 12 Mohindra S, Singla N, Gupta R , et al. CSF fistula through the umbilicus following a shunt surgery: a case report and literature review. Pediatr Neurosurg 2007; 43: 396-398
    CrossrefPubMedGoogle Scholar
  • 13 Mohite PN, Bhatnagar AM, Hathila VP , et al. Patent vitellointestinal duct with prolapse of inverted loop of small intestine: a case report. J Med Case Reports 2007; 1: 49
    CrossrefPubMedGoogle Scholar
  • 14 Pittman T, Williams D, Rathore M , et al. The role of ethylene oxide allergy in sterile shunt malfunctions. Br J Neurosurg 1994; 8 (1) 41-45
    CrossrefPubMedGoogle Scholar
  • 15 Ratilal B, Costa J, Sampaio C. Antibiotic prophylaxis for surgical introduction of intracranial ventricular shunts. Cochrane Database Syst Rev 2006; 3 CD005365
    PubMedGoogle Scholar
  • 16 Ratilal B, Costa J, Sampaio C. Antibiotic prophylaxis for surgical introduction of intracranial ventricular shunts: a systematic review. J Neurosurg Pediatr 2008; 1 (1) 48-56
    CrossrefPubMedGoogle Scholar
  • 17 Surchev J, Georgiev K, Enchev Y , et al. Extremely rare complications in cerebrospinal fluid shunt operations. J Neurosurg Sci 2002; 46: 100-102
    PubMedGoogle Scholar
  • 18 Tangsinmankong Jr N, Nelson RP, Good RA. Glucocorticosteroid treatment for cerebrospinal fluid eosinophilia in a patient with ventriculoperitonial shunt. Ann Allergy Asthma Immunol 1999; 83 (4) 341-342
    PubMedGoogle Scholar
  • 19 Turtas S, Orunesu G. Extrusion of peritoneal catheter through a thoracic skin fistula: report of a rare complication of ventriculoperitoneal shunt. Neurochirugia (Stuttgart) 1992; 35 (4) 121-122
    PubMedGoogle Scholar
  • 20 VandeVord PJ, Gupta N, Wilson RB , et al. Immune reactions associated with silicone-based ventriculo-peritoneal shunt malfunctions in children. Biomaterials 2004; 25 (17) 3853-3860
    CrossrefPubMedGoogle Scholar
  • 21 Weichert J, Chiriac A, Kaiser M , et al. Prenatal management of an allantoic cyst with patent urachus. Arch Gynecol Obstet 2009; 280: 321-323
    CrossrefPubMedGoogle Scholar