VENTRICULOPERITONEAL SHUNT BLOCKAGE
Abstract
Background: Hydrocephalus is the abnormal accumulation of cerebrospinal fluid within theventricles and subarachnoid spaces, resulting in increased intracranial pressure. The treatment of
choice is placement of ventriculoperitoneal shunt. Ventriculoperitoneal shunt blockage is not an
uncommon complication. Objective of the study was to find out the frequency, causes and site of
ventriculoperitoneal blockage and to compare it with other studies. Methods: This case series
study was conducted at Department of Neurosurgery Liaquat University Hospital, Jamshoro, from
April 2008 to March 2012. The records of 53 patients between 40 days to 45 years age presenting
with blocked ventriculoperitoneal shunt were included. All the patients underwent thorough
clinical examination and radiological investigations, and shunt revision done. The retrieved data
was collected on proforma. Frequencies and percentages were calculated for categorical data.
Results: Out of 53 patients 28 were males, 25 patients were females. Age of patients ranged from
40 days to 45 years. Time interval between the ventriculo-peritoneal shunt placement and
blockage of shunt ranged from 2 weeks to 9 years. Out of 53 patients, 32 (69.37%) patients had
obstruction at distal catheter, whereas 21 (39.62%) patients had ventricular catheter blockage.
Conclusion: Ventriculo-peritoneal shunt blockage is one of the most common complications of
shunt placement procedure. In this study most of the patients (69.37%) had distal catheter
obstruction. Majority (35.84%) of the patients presented with shunt obstruction within one year of
shunt placement. Shunt obstruction is common in children less than 3 years age.
Keywords: VP shunt, obstruction of shunt, revision
References
Hlatky R, Valadka AB, Robertson CS. Intracranial
Hypertension and cerebral ischemia after severe traumatic
brain injury. Neurosurg Focus 2003;14(1):1-4.
Bal RK, Singh P. Harjai MM. Intestinal volvulus: a rare
complication of ventriculoperitoneal shunt. Pediatr Surg Int
;15:577-8.
Ali M, Aman R, Khan Z, Khan KM, Siddique M. Khanzada K.
Frequency of causes of ventriculoperitoneal shunt failure in
hydrocephalus patients. J Postgrad Med Inst 2011;25:368-72.
Browd SR, Gottfrie ON, Ragel BT, Kestle JRW. Failure of
cerebrospinal fluid shunts: Part II: Over drainage, loculation
and abdominal complications. Pediat Neurol 2006;34:171-6.
Martinez-Lage JF, Ruiz-Espejo AM, Almagro M, Alfaro R,
Felipe-Murcia M, Lopez-Guerrero AL. CSF over drainage in
shunted intracranial arachnoid cysts: a series and review.
Childs Nerv Syst 2009;25:1061-9.
Martinez-Lage JF, Almagro M, Ruiz-Espejo AM, Leon M,
Garcia-Martinez S, Moralo S. Keeping CSF valve function
with urokinase in children with intraventricular hemorrhage
and CSF shunts. Childs Nerv Syst 2009;25 981-6.
Brownlee RD, Dold ONR, Myles ST. Intraventricular
hemorrhage complicating ventricular catheter revision:
incidence and effect on shunt survival. Pediatr Neurosurg
;22:315-20.
Esposito C, Porreca A, Gangemi M, Garipoli V, De Pasquale
M. The use of laparoscopy in the diagnosis and treatment of
abdominal complications of ventriculoperitoneal shunts in
children.Pediatr Surg Int 1998;13:352-4.
Lortat-Jacob S, Pierre-Kahn A, Renier D, Hirsch JF, Martelli
H, Pellerin D, et al. Abdominal complications of
ventriculoperitoneal shunts in children: 65 cases. Chir
Pediatr1984;25:17-21.
Sharma AK, Pandey AK, Diyora BD, Mamidanna R, Sayal
PP, Ingale HA. Abdominal CSF pseudocyst in a patient with
ventriculoperitoneal shunt. Indian J Surg 2004;66:360-3.
Oh A, Wildbrett P, Golub R,Yu LM, Goodrich J, Lee T.
Laparascopic repositioning of a ventriculoperitoneal catheter
tip for a sterile abdominal cerebrospinal fluid pseudocyst.
Surg Endosc 2001;15:518.
Lee TT, Uribe J, Ragheb J, Morrison G, Jagid JR. Unique
presentation of pediatric shunt malfunction. Pediatr
Neurosurg 1999;30:122-6.
Casey ATH, Kimmings EJ, Kleinugtebeld AD. The long term
outlook for hydrocephalus in childhood. Pediatr Neurosurg
; 27: 63-70.
Gaskill SJ, Marlin AE. Pseudocysts of the abdomen
associated with ventriculoperitoneal shunts: a report of
twelve cases and a review of the literature. Pediatr Neurosci
;15(1):23-6.
Sainte-Rose C, Piatt JH, Renier D, Pierre-Kahn A, Hirsch
JF, Hoffman HJ, et al. Mechanical complications in shunts.
Pediatr Neurosurg 1991-92;17(1):2-9.
Lazareff JA, Peacock W, Holly L, Ver Halen J, Wong
A, Olmstead C. Multiple shunt failures: an analysis of
relevant factors. Child Nerv Syst 1998;14:271-5.
Peacock WJ, Currer TH. Hydrocephalus in childhood: a
study of 440 cases. S Afr Med J 1984;66:323-4.
Rekate HI. Shunt revision: complications and their
prevention. Pediatr Neurosurg 1991-92;17:155-62.
Rainov N, Schobess A, Heidecke V, Burkert W. Abdominal
CSF pseudocysts in patients with ventriculo-peritoneal
shunts. Report of fourteen cases and review of the literature.
Acta Neurochir (Wien) 1994;127:73-8.
Blount JP, Campbell JA, Haines SJ. Complications in
ventricular cerebrospinal fluid shunting. Neurosurg Clin N
Am 1993;4:633-56.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
