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. 2023 Mar 17;10(3):571.
doi: 10.3390/children10030571.

Appendicitis and Peritonitis in Children with a Ventriculo-Peritoneal Shunt

Glenn M C Fröschle  1 , Johanna Hagens  1 , Philip Mannweiler  2 , Friederike Sophie Groth  3 , Gertrud Kammler  3 , Konrad Reinshagen  1 , Christian Tomuschat  1
Affiliations

Appendicitis and Peritonitis in Children with a Ventriculo-Peritoneal Shunt

Glenn M C Fröschle et al. Children (Basel). .

Abstract

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.

Keywords: appendicitis; children; surgical management; ventriculoperitoneal shunt.

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Conflict of interest statement

The authors declare no conflict of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Figures

Figure 1
Figure 1
Infected pseudocyst in a patient with VPS and acute appendicitis.
Figure 2
Figure 2
Overview of the surgical findings and reasons for acute abdomen in the patients included in this study.
See this image and copyright information in PMC

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