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Complications of Ventriculoperitoneal Shunts in Children with Pediatric Hydrocephalus a Local Study at Benha University Hospitals

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Last updated: 28 Dec 2024

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Abstract

Ventriculoperitoneal shunting is the main way used for extra-thecal cerebrospinal fluid (CSF) diversion. Despite being the main corner stone of treating different types of hydrocephalus, VP shunts has unfortunately a lot of  complications making surgeries to treat these complications much more than initial shunt insertions.Methods:It is a clinical retrospective observational study that was conducted on 221 patients wth congenital hydrocephalus of both genders with age ranging from 0 to 18 yrs old who came with symptoms and signs of shunt complications and were primarily shunted at Benha university hospital  between 2016 and 2019. A complete clinical assessment was done, history taking, a final diagnosis was made, and a treatment of individual patients was planned accordingly. Patients were followed up till the end of the study post-operatively. Data was analyzed using the SPSS (version 16.0). VP shunt was inserted for 221 patients. 113 (51.1%) patients had various forms of complications. Obstructive    complications accounts for  the most common complications  as they happened in 48 (42.5%) of complicated  patients followed by infective complications as they  appeared in  27 (24%) patients.Conclusions: Despite .great revolution in the field of neurosurgery in the past 100 years  and sincere efforts from neurosurgeons worldwide , shunt complications still common among shunted patients.Background Hydrocephalus is regarded as an imbalance in   the formation and absorption of CSF to a sufficient magnitude producing accumulation of CSF fluid with in ventricular system of the brain leading to an elevation of intracranial pressure. Compensatory adjustments especially in very young  subjects may occur that may reduce prevailing CSF pressure to normal range on count of functioning brain tissue [1]. Hydrocephalus is the second most common congenital brain malforma-tion [2].Congenital hydrocephalus is type of hydrocephalus that is present or its underlying cause at birth. majority of cases are attributed to aqueductal stenosis , chiarri malformation , dandy walker malformation ,arachnoid cyst. approximately 55% of all cases of congenital hydrocephalus are due to Primary aqueductal stenosis whereas aqueductal stenosis secondary to neoplasm, infection, or hemorrhage accounts for another 5% [4]. Till now , the standard treatment of hydrocephalus is ventriculoperitoneal shunt. The technique of using the peritoneal cavity for CSF absorption in ventriculoperitoneal shunting (VPS) was developed by Kausch in 1908 [3]. Al- though VPS insertion is the most common neurosurgical Procedure done worldwide, complication rates in Children are  high ranging from 10% to 100% [11]. The advent of endoscopic third ventriculostomy has gained popularity due to the high complication and failure rates of ventriculoperitoneal shunt [12]. VP shunts are prone to a lot of  complications such as mechanical blockage, shunt infection, shunt migration, and various abdominal complications[13].

DOI

10.21608/bjas.2021.169109

Authors

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M.B.

Last Name

Abd El-Wahab

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Affiliation

General Surgery Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

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First Name

H.M.

Last Name

Sobeih

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Affiliation

General Surgery Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

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Orcid

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First Name

M.M.

Last Name

El-Magraby

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Affiliation

Neurosurgery Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

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First Name

M.E.

Last Name

El-Hawary

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Affiliation

Neurosurgery Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

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First Name

A.I.

Last Name

Soliman

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-

Affiliation

General Surgery Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

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Volume

6

Article Issue

1

Related Issue

24493

Issue Date

2021-01-01

Receive Date

2021-02-05

Publish Date

2021-01-01

Page Start

205

Page End

212

Print ISSN

2356-9751

Online ISSN

2356-976X

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https://bjas.journals.ekb.eg/article_169109.html

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https://bjas.journals.ekb.eg/service?article_code=169109

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31

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Original Research Papers

Type Code

1,647

Publication Type

Journal

Publication Title

Benha Journal of Applied Sciences

Publication Link

https://bjas.journals.ekb.eg/

MainTitle

Complications of Ventriculoperitoneal Shunts in Children with Pediatric Hydrocephalus a Local Study at Benha University Hospitals

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Article

Created At

23 Jan 2023