The Experts below are selected from a list of 288 Experts worldwide ranked by ideXlab platform
Lorenzo F. Munoz - One of the best experts on this subject based on the ideXlab platform.
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ventriculoPeritoneal shunt with a rare twist small bowel ischemia and necrosis secondary to knotting of Peritoneal Catheter
Journal of Neurosurgery, 2014Co-Authors: Manish K Kasliwal, Roham Moftakhar, Lorenzo F. MunozAbstract:Small-bowel ischemia and necrosis due to knotting of the Peritoneal Catheter is an extremely rare complication related to a ventriculoPeritoneal shunt (VPS). A 3-month-old girl, with a history of Chiari II malformation and myelomeningocele (MM) after undergoing right occipital VPS insertion and MM repair at birth, presented to the emergency department with a high-grade fever. Examination of a CSF sample obtained via shunt tap raised suspicion for the presence of infection. Antibiotic therapy was initiated, and subsequently the VPS was removed and an external ventricular drain was placed. Intraoperatively, as attempts at pulling the distal Catheter from the scalp incision were met with resistance, the distal Catheter was cut and left in the abdomen while the remainder of the shunt system was successfully removed. While the patient was awaiting definitive shunt revision surgery to replace the VPS, she developed abdominal distension due to small-bowel obstruction. An emergency exploratory laparotomy revealed...
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ventriculoPeritoneal shunt with a rare twist small bowel ischemia and necrosis secondary to knotting of Peritoneal Catheter
Journal of Neurosurgery, 2014Co-Authors: Lee A Tan, Manish K Kasliwal, Roham Moftakhar, Lorenzo F. MunozAbstract:Small-bowel ischemia and necrosis due to knotting of the Peritoneal Catheter is an extremely rare complication related to a ventriculoPeritoneal shunt (VPS). A 3-month-old girl, with a history of Chiari II malformation and myelomeningocele (MM) after undergoing right occipital VPS insertion and MM repair at birth, presented to the emergency department with a high-grade fever. Examination of a CSF sample obtained via shunt tap raised suspicion for the presence of infection. Antibiotic therapy was initiated, and subsequently the VPS was removed and an external ventricular drain was placed. Intraoperatively, as attempts at pulling the distal Catheter from the scalp incision were met with resistance, the distal Catheter was cut and left in the abdomen while the remainder of the shunt system was successfully removed. While the patient was awaiting definitive shunt revision surgery to replace the VPS, she developed abdominal distension due to small-bowel obstruction. An emergency exploratory laparotomy revealed a knot in the distal Catheter looping around and strangulating the distal ileum, causing small-bowel ischemia and necrosis in addition to the obstruction. A small-bowel resection with ileostomy was performed, with subsequent placement of ventriculoatrial shunt for treatment of hydrocephalus. The authors report this exceedingly rare clinical scenario to highlight the fact that any retained distal Catheter must be carefully managed with immediate abdominal exploration to remove the distal Catheter to avoid bowel necrosis as pulling of a knotted Peritoneal Catheter may strangulate the bowel and cause ischemia, with significant clinical morbidity and possible mortality.
Tomoaki Kano - One of the best experts on this subject based on the ideXlab platform.
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Fibrous encapsulation of the Peritoneal Catheter in Peritoneal shunt: Case report
Surgical Neurology International, 2017Co-Authors: Tomoaki Kano, Hiromitsu KawauchiAbstract:BACKGROUND The authors report a case of fibrous encapsulation of the Peritoneal Catheter, which caused Peritoneal shunt malfunction, and has not previously been researched well as a complication of Peritoneal shunts. CASE DESCRIPTION A 69-year-old woman who had undergone a lumboPeritoneal (LP) shunt for communicative hydrocephalus following subarachnoid hemorrhage caused by a ruptured aneurysm was identified with malfunction of the LP shunt system by dementia and gait disturbance. Hydrocephalus was revealed on computed tomography (CT). Under a laparoscopy, the intraabdominal Peritoneal Catheter was observed to be obstructed by fibrous encapsulation covering it like a long white stocking. Although the fibrous encapsulating tissue was excised by laparoscopy forceps, a ventriculoPeritoneal shunt device was replaced with a new Peritoneal Catheter. The histopathological diagnosis of the surgically resected encapsulating tissue was the fibrous tissue with a few inflammation cells and a layer of lining cells surrounding some part of it. In the immunohistochemical study, a layer of lining cells surrounding the fibrous tissue showed immunohistochemically positive staining for calretinin. CONCLUSION The fibrous encapsulation would be formed by Peritoneal reaction to a Peritoneal Catheter as a foreign body by these histopathological and immunohistochemical analyses.
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Fibrous capsule formation of the Peritoneal Catheter tip in ventriculoPeritoneal shunt: Two case reports.
Surgical neurology international, 2014Co-Authors: Tomoaki KanoAbstract:A fibrous capsule formation of a Peritoneal Catheter tip has not previously been researched as a complication of ventriculoPeritoneal (VP) shunts. Two adult patients who had undergone a VP shunt for communicative hydrocephalus following subarachnoid hemorrhage caused by a ruptured aneurysm have been identified with malfunction of the VP shunt system by mild disturbance of consciousness and gait disturbance or loss of appetite. Hydrocephalus was diagnosed by computed tomography and the obstruction of the Peritoneal Catheter was revealed by shuntgraphy. Laparoscopy was performed and the Peritoneal Catheter tips were obstructed by fibrous white capsules that covered them. One was a thin membranous capsule like a stocking with two small endoluminal granulomas of the Peritoneal Catheter, and other one was a fibrous glossy white capsule like a sock. These fibrous capsules were excised by laparoscopy forceps without the conversion to a new Peritoneal Catheter. Following the procedure, the shunt functioned normally. The pathological diagnoses were peritoneum with foreign body reaction or hyalinization of membranous tissue surrounded by fibrous tissue. These fibrous capsules might be formed by the Peritoneal reaction to cerebrospinal fluid as a foreign material. As such, a periodic medical check should be scheduled since a fibrous capsule of the Peritoneal Catheter tip might be formed again.
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Fibrous capsule formation of the Peritoneal Catheter tip in ventriculoPeritoneal shunt: Two case reports
Surgical Neurology International, 2014Co-Authors: Tomoaki KanoAbstract:Background: A fibrous capsule formation of a Peritoneal Catheter tip has not previously been researched as a complication of ventriculoPeritoneal (VP) shunts. Case Description: Two adult patients who had undergone a VP shunt for communicative hydrocephalus following subarachnoid hemorrhage caused by a ruptured aneurysm have been identified with malfunction of the VP shunt system by mild disturbance of consciousness and gait disturbance or loss of appetite. Hydrocephalus was diagnosed by computed tomography and the obstruction of the Peritoneal Catheter was revealed by shuntgraphy. Laparoscopy was performed and the Peritoneal Catheter tips were obstructed by fibrous white capsules that covered them. One was a thin membranous capsule like a stocking with two small endoluminal granulomas of the Peritoneal Catheter, and other one was a fibrous glossy white capsule like a sock. These fibrous capsules were excised by laparoscopy forceps without the conversion to a new Peritoneal Catheter. Following the procedure, the shunt functioned normally. The pathological diagnoses were peritoneum with foreign body reaction or hyalinization of membranous tissue surrounded by fibrous tissue. Conclusion: These fibrous capsules might be formed by the Peritoneal reaction to cerebrospinal fluid as a foreign material. As such, a periodic medical check should be scheduled since a fibrous capsule of the Peritoneal Catheter tip might be formed again.
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Migration of a distal ventriculoPeritoneal shunt Catheter into the internal jugular vein and heart through the external jugular vein: case report.
Neurologia medico-chirurgica, 2010Co-Authors: Tomoaki Kano, Shuhei Kurosaki, Susumu Iwasa, Hirochiyo WadaAbstract:A 6-year-old boy had undergone ventriculoPeritoneal (VP) shunt for acute hydrocephalus because of a brain tumor at the age of 11 months, and presented with vomiting and somnolence after the shunt malfunctioned 6 days after VP shunt reconstruction, during which the right external jugular vein was injured during the tunneling process and the Peritoneal Catheter was not fixed to the peritoneum with a purse string suture. Radiography revealed an abnormal route of the Peritoneal Catheter, suggesting that the distal VP shunt Catheter had migrated into venous vasculature through the right external jugular vein. Computed tomography revealed that the Peritoneal Catheter had migrated into the internal jugular vein and the right atrium. At surgery, the Peritoneal Catheter was exposed through a small incision on the subclavicular region, was easily extracted from the internal jugular vein and the heart as there was no coiling or adhesion of the distal Catheter to the vascular tissues, and was repositioned into the peritoneum with weak fixing between the subcutaneous tissues of the right subclavicular region and the right abdominal rectus muscle fascia as a temporary emergency measure. Peritoneal shunt migration into the internal jugular vein and the heart through the external jugular vein can be lethal because of pulmonary infarction or arrhythmia, and must be detected as soon as possible. Periodic follow-up radiography should be scheduled after VP shunt placement, even in the absence of symptoms.
Manish K Kasliwal - One of the best experts on this subject based on the ideXlab platform.
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ventriculoPeritoneal shunt with a rare twist small bowel ischemia and necrosis secondary to knotting of Peritoneal Catheter
Journal of Neurosurgery, 2014Co-Authors: Manish K Kasliwal, Roham Moftakhar, Lorenzo F. MunozAbstract:Small-bowel ischemia and necrosis due to knotting of the Peritoneal Catheter is an extremely rare complication related to a ventriculoPeritoneal shunt (VPS). A 3-month-old girl, with a history of Chiari II malformation and myelomeningocele (MM) after undergoing right occipital VPS insertion and MM repair at birth, presented to the emergency department with a high-grade fever. Examination of a CSF sample obtained via shunt tap raised suspicion for the presence of infection. Antibiotic therapy was initiated, and subsequently the VPS was removed and an external ventricular drain was placed. Intraoperatively, as attempts at pulling the distal Catheter from the scalp incision were met with resistance, the distal Catheter was cut and left in the abdomen while the remainder of the shunt system was successfully removed. While the patient was awaiting definitive shunt revision surgery to replace the VPS, she developed abdominal distension due to small-bowel obstruction. An emergency exploratory laparotomy revealed...
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ventriculoPeritoneal shunt with a rare twist small bowel ischemia and necrosis secondary to knotting of Peritoneal Catheter
Journal of Neurosurgery, 2014Co-Authors: Lee A Tan, Manish K Kasliwal, Roham Moftakhar, Lorenzo F. MunozAbstract:Small-bowel ischemia and necrosis due to knotting of the Peritoneal Catheter is an extremely rare complication related to a ventriculoPeritoneal shunt (VPS). A 3-month-old girl, with a history of Chiari II malformation and myelomeningocele (MM) after undergoing right occipital VPS insertion and MM repair at birth, presented to the emergency department with a high-grade fever. Examination of a CSF sample obtained via shunt tap raised suspicion for the presence of infection. Antibiotic therapy was initiated, and subsequently the VPS was removed and an external ventricular drain was placed. Intraoperatively, as attempts at pulling the distal Catheter from the scalp incision were met with resistance, the distal Catheter was cut and left in the abdomen while the remainder of the shunt system was successfully removed. While the patient was awaiting definitive shunt revision surgery to replace the VPS, she developed abdominal distension due to small-bowel obstruction. An emergency exploratory laparotomy revealed a knot in the distal Catheter looping around and strangulating the distal ileum, causing small-bowel ischemia and necrosis in addition to the obstruction. A small-bowel resection with ileostomy was performed, with subsequent placement of ventriculoatrial shunt for treatment of hydrocephalus. The authors report this exceedingly rare clinical scenario to highlight the fact that any retained distal Catheter must be carefully managed with immediate abdominal exploration to remove the distal Catheter to avoid bowel necrosis as pulling of a knotted Peritoneal Catheter may strangulate the bowel and cause ischemia, with significant clinical morbidity and possible mortality.
Roham Moftakhar - One of the best experts on this subject based on the ideXlab platform.
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ventriculoPeritoneal shunt with a rare twist small bowel ischemia and necrosis secondary to knotting of Peritoneal Catheter
Journal of Neurosurgery, 2014Co-Authors: Manish K Kasliwal, Roham Moftakhar, Lorenzo F. MunozAbstract:Small-bowel ischemia and necrosis due to knotting of the Peritoneal Catheter is an extremely rare complication related to a ventriculoPeritoneal shunt (VPS). A 3-month-old girl, with a history of Chiari II malformation and myelomeningocele (MM) after undergoing right occipital VPS insertion and MM repair at birth, presented to the emergency department with a high-grade fever. Examination of a CSF sample obtained via shunt tap raised suspicion for the presence of infection. Antibiotic therapy was initiated, and subsequently the VPS was removed and an external ventricular drain was placed. Intraoperatively, as attempts at pulling the distal Catheter from the scalp incision were met with resistance, the distal Catheter was cut and left in the abdomen while the remainder of the shunt system was successfully removed. While the patient was awaiting definitive shunt revision surgery to replace the VPS, she developed abdominal distension due to small-bowel obstruction. An emergency exploratory laparotomy revealed...
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ventriculoPeritoneal shunt with a rare twist small bowel ischemia and necrosis secondary to knotting of Peritoneal Catheter
Journal of Neurosurgery, 2014Co-Authors: Lee A Tan, Manish K Kasliwal, Roham Moftakhar, Lorenzo F. MunozAbstract:Small-bowel ischemia and necrosis due to knotting of the Peritoneal Catheter is an extremely rare complication related to a ventriculoPeritoneal shunt (VPS). A 3-month-old girl, with a history of Chiari II malformation and myelomeningocele (MM) after undergoing right occipital VPS insertion and MM repair at birth, presented to the emergency department with a high-grade fever. Examination of a CSF sample obtained via shunt tap raised suspicion for the presence of infection. Antibiotic therapy was initiated, and subsequently the VPS was removed and an external ventricular drain was placed. Intraoperatively, as attempts at pulling the distal Catheter from the scalp incision were met with resistance, the distal Catheter was cut and left in the abdomen while the remainder of the shunt system was successfully removed. While the patient was awaiting definitive shunt revision surgery to replace the VPS, she developed abdominal distension due to small-bowel obstruction. An emergency exploratory laparotomy revealed a knot in the distal Catheter looping around and strangulating the distal ileum, causing small-bowel ischemia and necrosis in addition to the obstruction. A small-bowel resection with ileostomy was performed, with subsequent placement of ventriculoatrial shunt for treatment of hydrocephalus. The authors report this exceedingly rare clinical scenario to highlight the fact that any retained distal Catheter must be carefully managed with immediate abdominal exploration to remove the distal Catheter to avoid bowel necrosis as pulling of a knotted Peritoneal Catheter may strangulate the bowel and cause ischemia, with significant clinical morbidity and possible mortality.
Lee A Tan - One of the best experts on this subject based on the ideXlab platform.
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ventriculoPeritoneal shunt with a rare twist small bowel ischemia and necrosis secondary to knotting of Peritoneal Catheter
Journal of Neurosurgery, 2014Co-Authors: Lee A Tan, Manish K Kasliwal, Roham Moftakhar, Lorenzo F. MunozAbstract:Small-bowel ischemia and necrosis due to knotting of the Peritoneal Catheter is an extremely rare complication related to a ventriculoPeritoneal shunt (VPS). A 3-month-old girl, with a history of Chiari II malformation and myelomeningocele (MM) after undergoing right occipital VPS insertion and MM repair at birth, presented to the emergency department with a high-grade fever. Examination of a CSF sample obtained via shunt tap raised suspicion for the presence of infection. Antibiotic therapy was initiated, and subsequently the VPS was removed and an external ventricular drain was placed. Intraoperatively, as attempts at pulling the distal Catheter from the scalp incision were met with resistance, the distal Catheter was cut and left in the abdomen while the remainder of the shunt system was successfully removed. While the patient was awaiting definitive shunt revision surgery to replace the VPS, she developed abdominal distension due to small-bowel obstruction. An emergency exploratory laparotomy revealed a knot in the distal Catheter looping around and strangulating the distal ileum, causing small-bowel ischemia and necrosis in addition to the obstruction. A small-bowel resection with ileostomy was performed, with subsequent placement of ventriculoatrial shunt for treatment of hydrocephalus. The authors report this exceedingly rare clinical scenario to highlight the fact that any retained distal Catheter must be carefully managed with immediate abdominal exploration to remove the distal Catheter to avoid bowel necrosis as pulling of a knotted Peritoneal Catheter may strangulate the bowel and cause ischemia, with significant clinical morbidity and possible mortality.