Neurology India Medknow Publications on behalf of the Neurological Society of India ISSN: 0028-3886 EISSN: 1998-4022 Vol. 52, Num. 3, 2004, pp. 405-405

Neurology India, Vol. 52, No. 3, July-September, 2004, pp. 405

Letter To Editor

Lower end of ventriculoperitoneal shunt embedding in liver parenchyma

Chitkara Naveen, Gupta Rahul, Singla SL, Sharma NK

Department of Neurosurgery, Pt. B. D. Sharma PGIMS, Rohtak
Correspondence Address:Department of Neurosurgery, Pt. B. D. Sharma PGIMS, Rohtak

Code Number: ni04143

Sir,
Insertion of ventriculoperitoneal shunt is one of the commonest neurosurgical procedures. Though a safe and simple procedure, it is not devoid of complications. The common complications associated with shunt surgery are blockage, infection, over-drainage and malfunction.

A 5-year-old female child had a non-communicating hydrocephalus. A Medtronic moderate pressure ventriculoperitoneal shunt was inserted. After about 15 days of surgery, the patient developed headache, vomiting and low-grade fever and mild pain in abdomen. There was referral of pain to right shoulder. X-ray of the upper abdomen showed that the shunt tube was coiled in the right subdiaphragmatic region. Ultrasound abdomen revealed a cystic cavity in the right lobe of the liver with shunt tube inside it. CT scan abdomen [Figure - 1] was done, which showed shunt tube embedded in liver parenchyma and a cystic cavity around the tip of the tube. The patient was given preoperative cover of 3rd generation cephalosporin and the lower end was taken out. The shunt tube distal to the chamber was replaced by Chhabra MDR shunt and reinserted through a left inguinal incision. The postop erative period was uneventful. She was asymptomatic at 3 months follow-up and ultrasound abdomen showed resolution of the cyst in the right lobe of the liver.

There are numerous complications of the lower end of the shunt described in the literature. By the above case, the authors want to share their experience of this never before reported complication.

Copyright 2004 - Neurology India

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