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脑室腹腔分流术并发腹部假性囊肿:脑室胸腔分流术转换的罕见指征。

Abdominal pseudocyst complicating ventriculoperitoneal shunt: A rare indication for ventriculopleural shunt conversion.

作者信息

Shrestha Nishan, Gautam Naveen, Shrestha Merina

机构信息

Intern doctor Tribhuvan University Teaching Hospital Kathmandu Nepal.

Paediatrics Tribhuvan University Teaching Hospital Kathmandu Nepal.

出版信息

Clin Case Rep. 2023 Sep 7;11(9):e7902. doi: 10.1002/ccr3.7902. eCollection 2023 Sep.

Abstract

KEY CLINICAL MESSAGE

Abdominal pseudocyst is a rare complication of ventriculoperitoneal (VP) shunt placement. Ventriculopleural shunt (VPL) can be an effective treatment option for the recurrent complications of VP shunt failure.

ABSTRACT

Abdominal pseudocyst (APC) is a rare complication of ventriculoperitoneal (VP) shunt placement for the treatment of congenital hydrocephalus. This case report presents a two-and-a-half-year-old male child who underwent VP shunt placement for aqueductal stenosis-related hydrocephalus. The patient subsequently developed recurrent shunt failure and an APC, which was managed initially by surgical excision of the cyst and repositioning of the catheter. However, shunt failure recurred. The patient underwent ventriculopleural (VPL) shunt conversion as a more viable option for recurrent blockage. Postoperatively, the patient developed respiratory distress with massive pleural effusion, which was treated with chest tube insertion. This case highlights the complexity of managing congenital hydrocephalus and its rare complication, APC. Prompt recognition and appropriate management of APC can lead to improved outcomes and minimize the need for invasive procedures. VPL shunt conversion can be considered an alternative treatment option when other treatments have failed. Further research is needed to establish guidelines for the management of APC and determine the long-term effectiveness of VPL shunting.

摘要

关键临床信息

腹腔假性囊肿是脑室腹腔(VP)分流术的一种罕见并发症。脑室胸膜分流术(VPL)对于VP分流失败的复发性并发症可能是一种有效的治疗选择。

摘要

腹腔假性囊肿(APC)是先天性脑积水治疗中脑室腹腔(VP)分流术的一种罕见并发症。本病例报告介绍了一名两岁半男性儿童,因导水管狭窄相关脑积水接受了VP分流术。该患者随后出现复发性分流失败和APC,最初通过手术切除囊肿和重新放置导管进行处理。然而,分流失败再次出现。作为复发性堵塞的更可行选择,该患者接受了脑室胸膜(VPL)分流转换术。术后,患者出现呼吸窘迫并伴有大量胸腔积液,通过插入胸管进行治疗。本病例突出了先天性脑积水及其罕见并发症APC管理的复杂性。对APC的及时识别和适当管理可改善预后并减少侵入性操作的必要性。当其他治疗失败时,VPL分流转换术可被视为一种替代治疗选择。需要进一步研究以建立APC管理指南并确定VPL分流术的长期有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d0/10485240/bb6bbdc43282/CCR3-11-e7902-g005.jpg

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