TY - JOUR
T1 - Case report of mesenteric strangulation secondary to longstanding ventriculoperitoneal shunt catheter
AU - Grant, Matthew T.
AU - Wilson, Nicole A.
AU - Keller, Martin S.
AU - Huguenard, Anna L.
AU - Strahle, Jennifer M.
AU - Vrecenak, Jesse D.
N1 - Funding Information:
The authors would like to thank the multiple teams and providers who participated in this patient’s care, most notably the pediatric intensive care unit and the infectious disease team. Most importantly, many thanks are due to the patient and his family for their gratitude and kindness through such a difficult episode. The patient as well as his parent were in consent with publication of this case report.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.
PY - 2021/8
Y1 - 2021/8
N2 - Background: Ventriculoperitoneal (VP) shunts are the most common treatment for hydrocephalus in both pediatric and adult patients. Complications resulting from the abdominal portion of shunts include tube disconnection, obstruction of the shunt tip, catheter migration, infection, abdominal pseudocysts, and bowel perforation. However, other less common complications can occur. The authors present a unique case of a patient with a longstanding VP shunt presenting with an acute abdomen secondary to knotting of the peritoneal portion of the catheter tubing. Case description: A 13-year-old male with past medical history significant for myelomeningocele, requiring ventriculoperitoneal shunt placement at 18 months of age, presented to an outside hospital with chief complaint of abdominal pain. Cross-sectional imaging revealed spontaneous knot formation within the shunt tubing around the base of the small bowel mesentery. He was then transferred to our facility for general and neurosurgical evaluation. His abdominal exam was notable for diffuse distension in addition to tenderness to palpation with guarding and rebound. Given his tenuous clinical status and peritonitis, he was emergently booked for abdominal exploration. He underwent bowel resection, externalization of his shunt, with later re-anastomosis and shunt internalization. He eventually made a full recovery. Discussion: Given the potential for significant bowel loss with this and other shunt-related complications, this case serves as a reminder that even longstanding VP shunts should be considered in the differential diagnosis of abdominal pain in any patient with a shunt.
AB - Background: Ventriculoperitoneal (VP) shunts are the most common treatment for hydrocephalus in both pediatric and adult patients. Complications resulting from the abdominal portion of shunts include tube disconnection, obstruction of the shunt tip, catheter migration, infection, abdominal pseudocysts, and bowel perforation. However, other less common complications can occur. The authors present a unique case of a patient with a longstanding VP shunt presenting with an acute abdomen secondary to knotting of the peritoneal portion of the catheter tubing. Case description: A 13-year-old male with past medical history significant for myelomeningocele, requiring ventriculoperitoneal shunt placement at 18 months of age, presented to an outside hospital with chief complaint of abdominal pain. Cross-sectional imaging revealed spontaneous knot formation within the shunt tubing around the base of the small bowel mesentery. He was then transferred to our facility for general and neurosurgical evaluation. His abdominal exam was notable for diffuse distension in addition to tenderness to palpation with guarding and rebound. Given his tenuous clinical status and peritonitis, he was emergently booked for abdominal exploration. He underwent bowel resection, externalization of his shunt, with later re-anastomosis and shunt internalization. He eventually made a full recovery. Discussion: Given the potential for significant bowel loss with this and other shunt-related complications, this case serves as a reminder that even longstanding VP shunts should be considered in the differential diagnosis of abdominal pain in any patient with a shunt.
KW - Mesenteric strangulation
KW - Ventriculoperitoneal shunt (VP shunt)
UR - http://www.scopus.com/inward/record.url?scp=85098485784&partnerID=8YFLogxK
U2 - 10.1007/s00381-020-05019-1
DO - 10.1007/s00381-020-05019-1
M3 - Article
C2 - 33388923
AN - SCOPUS:85098485784
SN - 0256-7040
VL - 37
SP - 2719
EP - 2722
JO - Child's Nervous System
JF - Child's Nervous System
IS - 8
ER -