Rizk Elias, Dias Mark S, Verbrugge Joel, Boop Frederick A
Department of Neurosurgery, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
J Neurosurg Pediatr. 2009 Jun;3(6):525-8. doi: 10.3171/2009.2.PEDS08482.
Unusual complications of peritoneal shunts are a well-known occurrence. The authors present 2 cases of intracardiac migration of a distal shunt catheter, summarizing the diagnosis and management of each case. This complication seems to be a rare occurrence; the transgression of the jugular vein leading to intracardiac migration of a shunt catheter has been reported only 6 times previously. The authors highlight the importance of careful and proper placement of the distal peritoneal catheter during the tunneling process, in particular avoiding too deep a penetration of the shunt passer into the neck tissues and too medial a shunt passage near the sternal notch to avoid vascular structures.
腹膜分流术的异常并发症是众所周知的情况。作者介绍了2例远端分流导管心脏内迁移的病例,总结了每个病例的诊断和处理方法。这种并发症似乎很少见;此前仅有6次关于颈静脉侵犯导致分流导管心脏内迁移的报道。作者强调了在隧道形成过程中仔细正确放置远端腹膜导管的重要性,特别是要避免分流器过深地刺入颈部组织以及在胸骨切迹附近的分流通道过于偏内侧,以避开血管结构。