Ventricular Peritoneal Shunt

Risk Factors

The operation is generally safe with low surgical risk. Some of the risks encountered are as follows:

• Ileus
• Infection
• Obstruction
• Malplacement
• Wound breakdown with exposed shunt tubing

Rare but potentially more serious complications are listed below:

• Subdural hematoma
• Intracranial hematoma
• Bowel injury

Ileus

As the abdominal cavity is entered during operation, some patients may have slow gastric and bowel movement post operation and may experience feelings of nausea and vomiting. They may not tolerate full meals immediately post operation. These symptoms usually resolve spontaneously over time.

Infection

• Post operation symptoms and signs would include fever, vomiting, neck stiffness, redness along the shunt tract
• Most common organisms are S. epidermidis and S. aureus
• Treatment would be intravenous antibiotics, external ventricular drainage and removal of shunt

Obstruction

• Most often due to the head tip is obstructed with cells, choroid plexus, or debris. Diagnosis is based on recurrent signs of headache, vomiting and drowsiness confirmed by a computed tomography (CT) scan of the head or lumbar puncture
• Treatment usually entails revision of shunt

Malplacement

This occurs when the ventricular or peritoneal end of the shunt tubing is in a position which does not facilitate free flow of CSF. The result is poor CSF drainage and hydrocephalus does not resolve.

Wound breakdown/shunt tube exposure

This can occur when the wound does not heal well or the overlying skin is thin with minimal subcutaneous tissue layer resulting in wound breakdown.

Some risk factors include malnourishment, debilitated condition and prolonged steroid usage.