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Case Reports
. 2019 Jan;101(1):e5-e7.
doi: 10.1308/rcsann.2018.0147. Epub 2018 Oct 5.

Delayed presentation of iatrogenic ventriculoperitoneal shunt transection following laparoscopic weight loss surgery in a patient with idiopathic intracranial hypertension

U A Khan  1 , A Giamouriadis  1 , R S Bhangoo  1
Affiliations
Case Reports

Delayed presentation of iatrogenic ventriculoperitoneal shunt transection following laparoscopic weight loss surgery in a patient with idiopathic intracranial hypertension

U A Khan et al. Ann R Coll Surg Engl. 2019 Jan.

Abstract

Idiopathic intracranial hypertension is strongly associated with central obesity and consequential raised intra-abdominal pressure. If left untreated it poses significant risk to vision and can eventually cause blindness. Owing to its pathophysiology, this condition is managed by both medical and surgical specialities. When medical management fails neurosurgeons commonly treat idiopathic intracranial hypertension by permanent cerebrospinal fluid peritoneal shunting. Weight reduction surgery provides patients who are obese with a multitude of benefits and it is not uncommon for the general surgeon to be presented with a patient with idiopathic intracranial hypertension and a cerebrospinal fluid peritoneal shunt in place. This provides a potential challenging situation in weight-loss surgical procedures. We describe an interesting case where laparoscopic bariatric surgery resulted in transection of the abdominal catheter with a delayed presentation of recurrent symptoms and an abdominal cerebrospinal fluid collection in a patient with idiopathic intracranial hypertension. We discuss how this could be avoided and its management.

Keywords: Idiopathic intracranial hypertension; Intracranial hypertension; Pseudotumor cerebri; Ventriculoperitoneal shunt; Weight reduction surgery.

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Figures

Figure 1
Figure 1
Laceration of distal shunt tubing following laparoscopic bariatric surgery (left) and after distal shunt tubing retrieval and re-insertion in to the peritoneum (right).
Figure 2
Figure 2
Laparoscopic view of a distal catheter from a cerebrospinal fluid peritoneal shunt.
See this image and copyright information in PMC

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