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2021, Number 2

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Gaceta Médica Espirituana 2021; 23 (2)

Pediatric complications of ventriculoperitoneal shunt. Topic review

Téllez IR, Mosquera BG

Language: Spanish
References: 43
Page: 123-139
PDF size: 436.27 Kb.


ABSTRACT

Background: Hydrocephalus is a common pediatric disorder and ventriculoperitoneal shunting is the most commonly surgical technique used for its treatment. The prevalence of pediatric complications is a frequent problem that increases morbidity and mortality.
Objective: To systematize and update knowledge on pediatric ventriculoperitoneal complications.
Development: Complications associated to ventriculoperitoneal shunting are frequent and can be divided into three groups: mechanical, infectious and functional related to inconsistent drainage of cerebrospinal fluid, either by defect or excess. Within mechanical complications, obstruction has the highest incidence followed by disconnections and ruptures due to adhesions and calcifications formed in the subcutaneous tract over time. Late obstructions predominate in the distal end being a frequent cause of reinterventions. Infections of the system are the most serious and complex complications to treat and are accompanied by high mortality. They can be acute, subacute and late. Unlike identified factors may increase the incidence of complications, some related to the type of valve and the cause of hydrocephalus.
Conclusions: Cerebrospinal fluid shunts have been long the classic treatment for pediatric hydrocephalus, able to solve almost all of its different forms regardless of the cause. The key to success in avoiding complications lies in an adequate preoperative assessment and a rigorous surgical technique also endorsing infection prevention measures.


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