Sharma Rajan Kumar, Takagi Kiyoshi, Yamada Yasuhiro, Kawase Tsukasa, Kato Yoko
Department of Neurosurgery, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan.
Asian J Neurosurg. 2019 Jul-Sep;14(3):935-937. doi: 10.4103/ajns.AJNS_91_19.
Disconnection of proximal or distal catheter is seen more frequently in the complication of the lumboperitoneal (LP) shunt. A connective tissue sheath that forms around the peritoneal catheter of silicone shunt tubing is a normal biological response to foreign material. The literature did not establish whether the disconnected LP shunt can allow passage of cerebrospinal fluid (CSF) through the disconnected portion. However, proof of the passage of CSF through these sheaths has been reported in only one published study to date. We present a case of a young patient with disconnected LP shunt who reported patent persistent fibrous tract around the tube shunt. In conclusion, asymptomatic patients with shunt disconnection should be evaluated with shuntography for patency of fibrous sheath before removal of the shunt to avoid the possible complications.
近端或远端导管断开在腰大池-腹腔(LP)分流术并发症中更为常见。硅胶分流管腹腔导管周围形成的结缔组织鞘是对外来物质的正常生物学反应。文献中尚未确定断开的LP分流管是否能使脑脊液(CSF)通过断开部分。然而,迄今为止仅有一项已发表的研究报道了脑脊液通过这些鞘的证据。我们报告一例年轻患者,其LP分流管断开,该患者报告分流管周围存在持续通畅的纤维束。总之,对于分流管断开的无症状患者,在移除分流管之前应进行分流管造影以评估纤维鞘的通畅情况,以避免可能的并发症。