Adeolu A A, Komolafe E O, Abiodun A A, Adetiloye V A
Department of Surgery, Neurological Surgery Division, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun state, Nigeria.
Childs Nerv Syst. 2006 Feb;22(2):186-8. doi: 10.1007/s00381-005-1164-y. Epub 2005 May 28.
Symptomatic pleural effusion following ventriculoperitoneal (VP) shunt insertion is very rare. The patient was an 8-year-old girl who had VP shunt for hydrocephalus as a result of aqueductal stenosis. Six weeks after surgery, she presented with headache, vomiting and drowsiness. She developed respiratory distress with pain in the right lower chest region and right hypochondrium on admission.
Chest X-ray confirmed right hydrothorax and showed the tip of the peritoneal catheter in the right suprahepatic subphrenic space. Her symptoms abated after the catheter was repositioned from the subphrenic region to the general peritoneal cavity. Repeat chest X-ray confirmed the resolution of the hydrothorax.
Shunt review without thoracocentesis or thoracostomy is an effective treatment of symptomatic hydrothorax following VP shunt, especially when there is no intrathoracic shunt migration.
脑室腹腔(VP)分流术后出现症状性胸腔积液非常罕见。该患者为一名8岁女孩,因导水管狭窄导致脑积水而行VP分流术。术后六周,她出现头痛、呕吐和嗜睡。入院时,她出现呼吸窘迫,右下胸部和右季肋区疼痛。
胸部X线证实右侧胸腔积液,并显示腹膜导管尖端位于肝右上膈下间隙。将导管从膈下区域重新放置到一般腹腔后,她的症状缓解。重复胸部X线证实胸腔积液已消退。
在不进行胸腔穿刺或胸廓造口术的情况下进行分流检查是治疗VP分流术后症状性胸腔积液的有效方法,尤其是当胸腔内没有分流移位时。