Department of Neurosurgery, Fattouma Bourguiba University Hospital, Avenue Farhat Hached, 5000, Monastir, Tunisia.
Research Unity Interventional Radiology LR18SP08, University of Monastir, Monastir, Tunisia.
Childs Nerv Syst. 2023 Jul;39(7):1963-1968. doi: 10.1007/s00381-023-05923-2. Epub 2023 Mar 18.
Ventriculo-gallbladder shunt (VGS) has been recognized as a last-resort alternative to treat hydrocephalus when the peritoneum and/or other distal sites can no longer receive shunts. In some specific conditions, it may be conceded as a first-line treatment.
We report the case of a 6-month-old girl with progressive post-hemorrhagic hydrocephalus who presented a concomitant chronic abdominal symptom. Specific investigations ruled out acute infection and led to the diagnosis of chronic appendicitis. Both problems were managed in a one-stage salvage procedure consisting of laparotomy sanctioning to treat the abdominal pathology and seize the opportunity to perform a VGS as a first option since the abdomen is prone to ventriculoperitoneal shunt (VPS) failure.
Only few cases have reported the use of VGS as the first option to handle uncommon complex cases due to abdominal or cerebrospinal fluid (CSF) conditions. We wish to draw attention to VGS as an effective procedure not only in children with multiple shunt failures but also as first-line management in some selected cases.
当腹膜和/或其他远端部位不能再接受分流时，脑室-胆囊分流术（VGS）已被认为是治疗脑积水的最后手段。在某些特殊情况下，它可能被承认为一线治疗。
我们报告了一例 6 个月大的女孩，患有进行性出血后脑积水，同时伴有慢性腹部症状。具体的检查排除了急性感染，并导致慢性阑尾炎的诊断。两个问题都在一个阶段的抢救程序中得到解决，包括剖腹手术来治疗腹部病变，并抓住机会将 VGS 作为首选，因为腹部容易发生脑室-腹腔分流术（VPS）失败。
由于腹部或脑脊液（CSF）状况，只有少数病例报告了将 VGS 作为首选来处理罕见的复杂病例。我们希望引起人们对 VGS 的关注，不仅在多次分流失败的儿童中，而且在某些选定的病例中也作为一线治疗。
