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. 2016 Jan 27:5:90.
doi: 10.1186/s40064-016-1738-z. eCollection 2016.

Pleural effusion in a child with a ventriculoperitoneal shunt and congenital heart disease

Jennifer Henningfeld  1 , Rohit S Loomba  2 , Santiago Encalada  1 , Kristin Magner  3 , Jennifer Pfister  3 , Anne Matthews  4 , Andrew Foy  4 , Theresa Mikhailov  3
Affiliations

Pleural effusion in a child with a ventriculoperitoneal shunt and congenital heart disease

Jennifer Henningfeld et al. Springerplus. .

Abstract

We present the unique case of an 8 month old infant who required extracorporeal membrane oxygenation (ECMO) after neonatal repair of tetralogy of Fallot. While on ECMO, he developed grade 3 intraventricular hemorrhage resulting in hydrocephalus requiring ventriculoperitoneal (VP) shunt placement at 5 months of life. He presented to cardiology clinic with a 2-month history of poor weight gain, tachypnea, and grunting and was found to have a large right sided pleural effusion. This was proven to be cerebrospinal fluid (CSF) accumulation secondary to poor peritoneal absorption with subsequent extravasation of CSF into the thoracic cavity via a diaphragmatic defect. After diaphragm repair, worsening ascites from peritoneal malabsorption led to shunt externalization and ultimate conversion to a ventriculoatrial (VA) shunt. This is the second reported case of VA shunt placement in a child with congenital heart disease and highlights the need to consider CSF extravasation as the cause of pleural effusions in children with VP shunts.

Keywords: Congenital heart disease; Effusion; Shunt; Ventriculoatrial; Ventriculoperitoneal.

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