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Intrathecal Baclofen Pump Migration Into the Peritoneal Cavity: A Case Report
INTRODUCTION: Intrathecal baclofen pumps are valuable treatment options for those with cerebral palsy. Although subfascial baclofen pump placement is generally preferred over a subcutaneous pump placement due to lower infection rates, rare complications can occur with the subfascial approach such as...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Kowsar
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5018100/ https://www.ncbi.nlm.nih.gov/pubmed/27642571 http://dx.doi.org/10.5812/aapm.33031 |
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author | Kovanda, Timothy J. Pestereva, Ecaterina Lee, Albert |
author_facet | Kovanda, Timothy J. Pestereva, Ecaterina Lee, Albert |
author_sort | Kovanda, Timothy J. |
collection | PubMed |
description | INTRODUCTION: Intrathecal baclofen pumps are valuable treatment options for those with cerebral palsy. Although subfascial baclofen pump placement is generally preferred over a subcutaneous pump placement due to lower infection rates, rare complications can occur with the subfascial approach such as pump migration. CASE PRESENTATION: The authors here describe a case of baclofen pump migration into the peritoneal cavity of a 26-year-old male patient with cerebral palsy, shunted hydrocephalus, and epilepsy. Because the patient’s pump could not be palpated on exam and hence refilled, imaging was undertaken, but did not reveal clear evidence of pump migration. Surgery afterward confirmed that the pump had migrated into the peritoneal cavity through a fascial defect. Baclofen pump had to be replaced instead subcutaneously as well as the patient later had to be readmitted for 2 ventriculoperitoneal shunt revisions due to progression of his hydrocephalus. CONCLUSIONS: Intraperitoneal migration of a subfascially placed baclofen pump is a rare, yet serious complication, which has been reported only once in the literature. We advise neurosurgeons to have a low level of threshold in confirming the location of a baclofen pump with imaging and surgical exploration if necessary in order to avoid detrimental outcomes such as bowel perforation. |
format | Online Article Text |
id | pubmed-5018100 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Kowsar |
record_format | MEDLINE/PubMed |
spelling | pubmed-50181002016-09-16 Intrathecal Baclofen Pump Migration Into the Peritoneal Cavity: A Case Report Kovanda, Timothy J. Pestereva, Ecaterina Lee, Albert Anesth Pain Med Case Report INTRODUCTION: Intrathecal baclofen pumps are valuable treatment options for those with cerebral palsy. Although subfascial baclofen pump placement is generally preferred over a subcutaneous pump placement due to lower infection rates, rare complications can occur with the subfascial approach such as pump migration. CASE PRESENTATION: The authors here describe a case of baclofen pump migration into the peritoneal cavity of a 26-year-old male patient with cerebral palsy, shunted hydrocephalus, and epilepsy. Because the patient’s pump could not be palpated on exam and hence refilled, imaging was undertaken, but did not reveal clear evidence of pump migration. Surgery afterward confirmed that the pump had migrated into the peritoneal cavity through a fascial defect. Baclofen pump had to be replaced instead subcutaneously as well as the patient later had to be readmitted for 2 ventriculoperitoneal shunt revisions due to progression of his hydrocephalus. CONCLUSIONS: Intraperitoneal migration of a subfascially placed baclofen pump is a rare, yet serious complication, which has been reported only once in the literature. We advise neurosurgeons to have a low level of threshold in confirming the location of a baclofen pump with imaging and surgical exploration if necessary in order to avoid detrimental outcomes such as bowel perforation. Kowsar 2016-03-12 /pmc/articles/PMC5018100/ /pubmed/27642571 http://dx.doi.org/10.5812/aapm.33031 Text en Copyright © 2016, Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM). http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited. |
spellingShingle | Case Report Kovanda, Timothy J. Pestereva, Ecaterina Lee, Albert Intrathecal Baclofen Pump Migration Into the Peritoneal Cavity: A Case Report |
title | Intrathecal Baclofen Pump Migration Into the Peritoneal Cavity: A Case Report |
title_full | Intrathecal Baclofen Pump Migration Into the Peritoneal Cavity: A Case Report |
title_fullStr | Intrathecal Baclofen Pump Migration Into the Peritoneal Cavity: A Case Report |
title_full_unstemmed | Intrathecal Baclofen Pump Migration Into the Peritoneal Cavity: A Case Report |
title_short | Intrathecal Baclofen Pump Migration Into the Peritoneal Cavity: A Case Report |
title_sort | intrathecal baclofen pump migration into the peritoneal cavity: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5018100/ https://www.ncbi.nlm.nih.gov/pubmed/27642571 http://dx.doi.org/10.5812/aapm.33031 |
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