Valletta E, Angelini G, Castagnini A, Fontana E, Piccoli R, Ulmi D
Clinica Pediatrica, Università di Verona, Policlinico GB Rossi, Verona.
Pediatr Med Chir. 2003 Sep-Oct;25(5):360-3.
The complications of percutaneous endoscopic gastrostomy (PEG) placement or replacement or of home management of gastrostomy, must be taken in account in patients with hydrocephalus and ventriculoperitoneal shunt. In this report we describe four children with spastic quadriplegia and ventriculoperitoneal shunt who had a median follow-up of 15 months (range 4-32 months) after PEG placement. Intravenous antibiotic prophylaxis was always used during routine procedures and no shunt infection was observed. In a patient, during accidental PEG dislodgement, peritoneal infection developed that required temporary diversion of the catheter. A second dislodgement, in the same individual, determined a large amount of serous peritoneal fluid that needed to be evacuated but no shunt infection or malfunction. In nobody of our patients, the shunt, located in the upper left abdomen, interfered with gastrostomy placement. Our experience confirms that PEG is not contraindicated in patients with ventriculoperitoneal shunt, provided that the risks of catheter infection are known and prevented.
对于脑积水和脑室腹腔分流术患者，必须考虑经皮内镜下胃造口术（PEG）置管或置换以及胃造口术家庭管理的并发症。在本报告中，我们描述了4例痉挛性四肢瘫痪且行脑室腹腔分流术的儿童，他们在PEG置管后中位随访15个月（范围4 - 32个月）。常规操作期间始终使用静脉抗生素预防，未观察到分流感染。1例患者在PEG意外移位期间发生了腹膜感染，需要临时改道引流导管。同一患者再次发生移位，导致大量浆液性腹腔积液需要排出，但未发生分流感染或故障。在我们所有患者中，位于左上腹的分流管均未干扰胃造口术置管。我们的经验证实，只要了解并预防导管感染风险，PEG在脑室腹腔分流术患者中并非禁忌。
