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丹迪-沃克畸形患儿经肛门排出异常脑室腹腔(VP)分流管:一例罕见病例报告

Unusual Ventriculoperitoneal (VP) Shunt Tube Extrusion through Anus in a Child with Dandy Walker Malformation: A Rare Case Report.

作者信息

Bansal Hanish, Gupta Gulzar, Gupta Mayank, Kaushal Rakesh

机构信息

Assistant Professor, Department of Neurosurgery, Dmc & H , Ludhiana, Punjab, India .

Resident, Department of Surgery, Dmc & H , Ludhiana, Punjab, India .

出版信息

J Clin Diagn Res. 2015 Jan;9(1):PD25-6. doi: 10.7860/JCDR/2015/11354.5488. Epub 2015 Jan 1.

Abstract

Aim of this paper is to report a case of extrusion of Ventriculo peritoneal shunt tube through anus in a one year female child ( k/c/o dandy walker malformation ) treated with placement of ventriculo peritoneal shunt for post operative hydrocephalus after excision of Subtorcular occipital meningocoel. The exact cause of such extrusion is not known. Unusual migration of distal catheter tip of VP shunt is a rare and bowel perforation is reported to occur between 0.1% and 0.7%. The possible factors responsible for this complication are thin bowel wall in children, sharp and stiff end of the VP shunt, use of trocar by some surgeons, chronic irritation by the shunt, previous surgery, infection and silicone allergy. In view of the potential for meningitis prompt and aggressive management is essential to avoid morbidity and mortality.

摘要

本文旨在报告一例1岁女童(患有丹迪-沃克畸形)的脑室腹腔分流管经肛门脱出病例。该女童因枕下脑膨出切除术后脑积水接受了脑室腹腔分流术。这种脱出的确切原因尚不清楚。脑室腹腔分流术远端导管尖端异常移位较为罕见,据报道肠穿孔发生率在0.1%至0.7%之间。导致这一并发症的可能因素包括儿童肠壁薄、脑室腹腔分流管末端尖锐坚硬、部分外科医生使用套管针、分流管的慢性刺激、既往手术、感染和硅胶过敏。鉴于存在脑膜炎的可能性,迅速而积极的处理对于避免发病和死亡至关重要。

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