Solmaz Ilker, Tehli Ozkan, Kaya Serdar, Erdogan Ersin, Izci Yusuf
Gulhane Military Medical Academy, Department of Neurosurgery, Ankara, Turkey.
Turk Neurosurg. 2011;21(3):421-2. doi: 10.5137/1019-5149.JTN.2924-10.2.
Pneumothorax is a very rare complication of ventriculoperitoneal shunting in children. We report a case of an iatrogenic bilateral tension pneumothorax during the placement of a subdural-peritoneal shunting. After the placement of peritoneal catheter, oxygen saturation of the patient quickly decreased, hypotension and bradycardia occurred. Intraoperative x-rays showed the pneumothorax. A thoracostomy tube was inserted and attached to an underwater seal. Vital signs improved in a short time period. The radiological improvement had been achieved in four days. Early diagnosis and prompt intervention are life-saving for this complication. To avoid this complication, the tip of the shunt tunneler should be always palpable during the placement of the peritoneal catheter, especially in children's shunt surgery.
气胸是儿童脑室腹腔分流术非常罕见的并发症。我们报告一例在硬膜下-腹腔分流管置入过程中发生的医源性双侧张力性气胸病例。在置入腹腔导管后，患者的血氧饱和度迅速下降，出现低血压和心动过缓。术中X线显示气胸。插入胸腔引流管并连接到水封瓶。生命体征在短时间内得到改善。四天后影像学表现得到改善。对于这种并发症，早期诊断和及时干预可挽救生命。为避免这种并发症，在置入腹腔导管时，尤其是在儿童分流手术中，应始终能摸到分流隧道器的尖端。
