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Journal of Korean Neurosurgical Society 1999;28(11): 1649-1652.
Two Unusual Complications of Ventriculoperitoneal Shunts.
Sung Won Cho, Bum Tae Kim, Hack Gun Bae, Jae Chil Chang, Won Han Shin, Soon Kwan Choi, Bark Jang Byun
Department of Neurosurgery, College of Medicine, Soonchunhyang University, Seoul, Korea.
The authors report two unusual complications of ventriculoperitoneal(VP) shunt, fractured ventricular catheter and the development of a huge cyst in breast. One patient, a 2-year-old male with a history of VP shunt operation due to bacterial meningitis two years ago, presented with a drowsy consciousness and gait disturbance after trivial head injury. When shaving the scalp for the shunt revision, small dimpling site which corresponded with the head injury site, was found. On the operative field, the ventricular catheter was found to be fractured at the valve connector. The other patient, a 24-year-old female who had undergone VP shunt due to tuberculous meningitis 2 months after a laparotomy 3 years ago, presented with a progressive enlargement of the right breast 2 months prior to admission. Radiologically, the breast appeared as a cystic mass containing the shunt catheter tip. The patient underwent ventriculoatrial shunt due to the repeated extraperitoneal migration of peritoneal catheter which resulted from the intraperitoneal adhesion. Not only an intense intraperitoneal adhesion but also trivial head injury may have caused the shunt failure. Precise history taking and physical examination are important to detect the cause of shunt failure. The possible mechanisms of the shunt failures are discussed.
Key Words: Shunt complication; Fractured ventricular catheter; Breast cyst; Extraperitoneal migration; Intraperitoneal adhesion
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