Fröschle Glenn M C, Hagens Johanna, Mannweiler Philip, Groth Friederike Sophie, Kammler Gertrud, Reinshagen Konrad, Tomuschat Christian
Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
Central Controlling Division, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
Children (Basel). 2023 Mar 17;10(3):571. doi: 10.3390/children10030571.
The purpose of this study was to outline the management of patients with appendicitis and ventriculoperitoneal shunt (VPS) in the largest pediatric surgery department in Germany. Patients with VPS presenting with an acute abdomen between 2012 and 2022 at a tertiary-care pediatric facility were the subject of a retrospective descriptive analysis. Patients were divided into two groups based on their diagnoses: group A (appendicitis) and group B (primary peritonitis). Medical records were analyzed to look at the diagnostics, operative approach, complications, peritoneal and liquor culture, and antibiotic treatment. A total of seventeen patients were examined: seven patients in group A and ten individuals in group B. In the present study patients in group A typically presented younger, sicker, and with more neurological symptoms than those in group B. All patients with appendicitis had their VPS exteriorized, and a new shunt system into the peritoneum was reimplanted 20 days later. Surgery should be aggressively administered to patients who present with an acute abdomen and a VPS. Change of the whole shunt system is suggested. Shunt infection and dysfunction should be ruled out in patients with abdominal symptoms, and surgical care should be started with a low threshold.
本研究的目的是概述德国最大的儿科外科对阑尾炎合并脑室腹腔分流术(VPS)患者的管理。2012年至2022年期间,在一家三级护理儿科机构中出现急腹症的VPS患者是一项回顾性描述性分析的对象。根据诊断将患者分为两组:A组(阑尾炎)和B组(原发性腹膜炎)。分析病历以查看诊断、手术方法、并发症、腹腔和脑脊液培养以及抗生素治疗情况。总共检查了17例患者:A组7例患者,B组10例患者。在本研究中,A组患者通常比B组患者年龄更小、病情更重且有更多神经症状。所有阑尾炎患者的VPS均外置,20天后重新植入一个新的进入腹膜的分流系统。对于出现急腹症和VPS的患者应积极进行手术治疗。建议更换整个分流系统。对于有腹部症状的患者应排除分流感染和功能障碍,并且应低门槛启动手术治疗。