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The shadow in the darkness: Case report on adhesive intestinal obstruction secondary to ventriculoperitoneal shunt catheter in an elderly patient

INTRODUCTION: Shunt placement is an effective therapy for hydrocephalus. Ventriculoperitoneal shunt draining excess cerebrospinal fluid connects the cerebral ventricles to the abdominal cavity. However, intestinal obstruction may ensue as an infrequent complication of the shunt. CASE PRESENTATION: A...

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Autores principales: Xue, Ying, Mranda, Geofrey Mahiki, Wei, Tian, Wang, Yu, Zhou, Xing-Guo, Liu, Zi-Ping, Gao, Zhong-Xia, Ding, Yin-Lu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142647/
https://www.ncbi.nlm.nih.gov/pubmed/35638005
http://dx.doi.org/10.1016/j.amsu.2022.103661
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author Xue, Ying
Mranda, Geofrey Mahiki
Wei, Tian
Wang, Yu
Zhou, Xing-Guo
Liu, Zi-Ping
Gao, Zhong-Xia
Ding, Yin-Lu
author_facet Xue, Ying
Mranda, Geofrey Mahiki
Wei, Tian
Wang, Yu
Zhou, Xing-Guo
Liu, Zi-Ping
Gao, Zhong-Xia
Ding, Yin-Lu
author_sort Xue, Ying
collection PubMed
description INTRODUCTION: Shunt placement is an effective therapy for hydrocephalus. Ventriculoperitoneal shunt draining excess cerebrospinal fluid connects the cerebral ventricles to the abdominal cavity. However, intestinal obstruction may ensue as an infrequent complication of the shunt. CASE PRESENTATION: A 65 years old female patient presented with abdominal pain, abdominal bloating, and ceased passage of flatus and stool for six days. She had a history of undergoing a VP shunt procedure due to midbrain obstruction and supratentorial hydrocephalus. Conservative treatment at another local hospital couldn't relieve her symptoms. Laboratory investigations revealed elevated CRP and neutrophils. CT scan showed distended small bowel loops with aerated effusion. Thus, she was admitted to our hospital and underwent an emergent laparotomy following diagnostic modalities completion. DISCUSSION: Adhesive intestinal obstruction secondary to ventriculoperitoneal shunt is a rare but fatal shunt complication. The possible mechanisms involved include rubbing movements between the greater omentum and the catheter, cerebrospinal fluid reaction with abdominal organs, immunological rejection of the catheter, and deposition of brain tumor cells with the resultant abdominal metastatic lesions. Laparoscopic and laparotomy are warranted in the surgical management of the disease. CONCLUSION: A high index of suspicion for adhesive intestinal obstruction is key to timely diagnosis and treatment.
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spelling pubmed-91426472022-05-29 The shadow in the darkness: Case report on adhesive intestinal obstruction secondary to ventriculoperitoneal shunt catheter in an elderly patient Xue, Ying Mranda, Geofrey Mahiki Wei, Tian Wang, Yu Zhou, Xing-Guo Liu, Zi-Ping Gao, Zhong-Xia Ding, Yin-Lu Ann Med Surg (Lond) Case Report INTRODUCTION: Shunt placement is an effective therapy for hydrocephalus. Ventriculoperitoneal shunt draining excess cerebrospinal fluid connects the cerebral ventricles to the abdominal cavity. However, intestinal obstruction may ensue as an infrequent complication of the shunt. CASE PRESENTATION: A 65 years old female patient presented with abdominal pain, abdominal bloating, and ceased passage of flatus and stool for six days. She had a history of undergoing a VP shunt procedure due to midbrain obstruction and supratentorial hydrocephalus. Conservative treatment at another local hospital couldn't relieve her symptoms. Laboratory investigations revealed elevated CRP and neutrophils. CT scan showed distended small bowel loops with aerated effusion. Thus, she was admitted to our hospital and underwent an emergent laparotomy following diagnostic modalities completion. DISCUSSION: Adhesive intestinal obstruction secondary to ventriculoperitoneal shunt is a rare but fatal shunt complication. The possible mechanisms involved include rubbing movements between the greater omentum and the catheter, cerebrospinal fluid reaction with abdominal organs, immunological rejection of the catheter, and deposition of brain tumor cells with the resultant abdominal metastatic lesions. Laparoscopic and laparotomy are warranted in the surgical management of the disease. CONCLUSION: A high index of suspicion for adhesive intestinal obstruction is key to timely diagnosis and treatment. Elsevier 2022-04-26 /pmc/articles/PMC9142647/ /pubmed/35638005 http://dx.doi.org/10.1016/j.amsu.2022.103661 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Xue, Ying
Mranda, Geofrey Mahiki
Wei, Tian
Wang, Yu
Zhou, Xing-Guo
Liu, Zi-Ping
Gao, Zhong-Xia
Ding, Yin-Lu
The shadow in the darkness: Case report on adhesive intestinal obstruction secondary to ventriculoperitoneal shunt catheter in an elderly patient
title The shadow in the darkness: Case report on adhesive intestinal obstruction secondary to ventriculoperitoneal shunt catheter in an elderly patient
title_full The shadow in the darkness: Case report on adhesive intestinal obstruction secondary to ventriculoperitoneal shunt catheter in an elderly patient
title_fullStr The shadow in the darkness: Case report on adhesive intestinal obstruction secondary to ventriculoperitoneal shunt catheter in an elderly patient
title_full_unstemmed The shadow in the darkness: Case report on adhesive intestinal obstruction secondary to ventriculoperitoneal shunt catheter in an elderly patient
title_short The shadow in the darkness: Case report on adhesive intestinal obstruction secondary to ventriculoperitoneal shunt catheter in an elderly patient
title_sort shadow in the darkness: case report on adhesive intestinal obstruction secondary to ventriculoperitoneal shunt catheter in an elderly patient
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142647/
https://www.ncbi.nlm.nih.gov/pubmed/35638005
http://dx.doi.org/10.1016/j.amsu.2022.103661
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