[Abdominal complications of ventriculo-peritoneal shunts in children. 65 cases]

Abstract

From 1971 to 1982, among 1 200 children with hydrocephalus cured by ventriculo-peritoneal shunt, 65 have presented an abdominal complication. Some of them are rare and easily explainable: 2 intra-operative viscus perforations, 1 intestinal obstruction, 3 extrusions of the catheter into an inguinal hernia. Also rare, C.S.F. ascites (5 cases) et C.S.F. pseudocysts (3 cases) presented with typical symptomatology easily diagnosed, but their etiology is not clear. The main complications are peritonitis without perforation (32 cases) and migrations of the catheter in the colon (19 cases): their etiology is an intra-operative bacterial contamination, they happen during the following weeks or months after the shunt procedure. They are associated with 8 among 9 deaths of our data by gram negative germ meningitis. Removal of the peritoneal catheter and temporary external shunt are their main treatment.