Dutta Gautam, Srivastava Arvind K, Jagetia Anita, Singh Daljit, Singh Hukum
Department of Neurosurgery, Govind Ballav Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
J Pediatr Neurosci. 2018 Oct-Dec;13(4):486-489. doi: 10.4103/JPN.JPN_63_18.
Coiling of peritoneal catheter is a rare complication associated with ventriculoperitoneal shunt procedures performed for the treatment of hydrocephalus. In most of the reported cases, coiling is associated with shunt migration resulting in shunt malfunction.
Here, we report two cases where spontaneous coiling of peritoneal end was observed following insertion of shunt, one of which was also associated with pseudocyst formation, which was clinically silent. Interestingly, in both the patients, shunt system was intact. We describe the clinical features, management, and possible mechanism of this feature.
In asymptomatic coiling of the peritoneal catheter, the patient should be kept in close observation as these groups of patients may be vulnerable to malfunction, and timely intervention may save the patient from further abdominal and cranial complications. Patients presenting with shunt malfunction should get abdominal evaluation performed to look for silent pseudocyst formation over and above a cranial computed tomography and shunt series.
腹膜导管盘绕是与用于治疗脑积水的脑室腹腔分流术相关的一种罕见并发症。在大多数报道的病例中，盘绕与分流管移位相关，导致分流管功能障碍。
在此，我们报告两例在分流管插入后观察到腹膜端自发盘绕的病例，其中一例还伴有假性囊肿形成，临床上无明显症状。有趣的是，两名患者的分流系统均完好无损。我们描述了该特征的临床特点、处理方法及可能机制。
对于腹膜导管无症状性盘绕的患者，应密切观察，因为这类患者可能易发生功能障碍，及时干预可使患者避免进一步的腹部和颅脑并发症。出现分流管功能障碍的患者除了进行头颅计算机断层扫描和分流管系列检查外，还应进行腹部评估，以查找隐匿的假性囊肿形成情况。
