[Abdominal complications of the ventriculo peritoneal derivations].

Abstract

Thirty-nine ventriculo-peritoneal shunts in children have been analyzed since 1962 to 1976 at the Neurological Institute in Montevideo. In these cases there were 8 important abdominal complications (20%): 7 were associated with ventriculitis, all with infiltration or fistula on the trajet, 3 cases were operated on because of intestinal occlusion, 1 of them with perforative acute peritonitis. In the others, gastric distention, abdominal distention, and transient ileus were found. Five patients died, 4 of them with ventriculitis, 3 children who had suffered ventriculitis, survived. They overcame their hydrocephalus by means of ventriculo-atrial shunts, afterwards their infection was cured. From the result of the test of these cases it is gathered in view of a ventriculo-peritoneal shunt disfunction, that it is necessary to: 1) As far as possible rule out ventriculitis. 2) In cases in which ventriculitis should be proved to exist and with a peritoneal reject, after the infection has been cured, one should not insist with the ventriculo-peritoneal diversion, because in this case the possibility of the relapse taking into account the abdominal intolerance, increases. After the ventriculitis should be got over with a proper bacteriological control, a ventriculo-atrial shunt must be performed. 3) The changing of the form of the divertion system is considered immediately after an abdominal aseptic intolerance is present (ileus, ascites, etc.), due to the double risk of intestinal occlusion or ventriculitis.