The Experts below are selected from a list of 3462 Experts worldwide ranked by ideXlab platform
Anil Nanda - One of the best experts on this subject based on the ideXlab platform.
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Ventriculoperitoneal Shunt surgery outcome in adult transition patients with pediatric onset hydrocephalus
Neurosurgery, 2012Co-Authors: Kesava G Reddy, Papireddy Bollam, Gloria Caldito, Bharat Guthikonda, Anil NandaAbstract:Background Ventriculoperitoneal Shunting remains the most widely used neurosurgical procedure for the management of hydrocephalus, albeit with many complications. Objective To review and assess the long-term clinical outcome of Ventriculoperitoneal Shunt surgery in adult transition patients with pediatric-onset hydrocephalus. Methods Patients 17 years or older who underwent Ventriculoperitoneal Shunt placement for hydrocephalus during their pediatric years (younger than 17 years) were included. Medical charts, operative reports, imaging studies, and clinical follow- up evaluations were reviewed and analyzed retrospectively. Results A total of 105 adult patients with pediatric-onset hydrocephalus were included. The median age of the patients was 25.9 years. The median age at the time of the initial Ventriculoperitoneal Shunt placement was 1.0 year. The median follow-up time for all patients was 17.7 years. The incidence of Shunt failure at 6 months was 15.2%, and the overall incidence of Shunt failure was 82.9%. Single Shunt revision occurred in 26.7% of the patients, and 56.2% had multiple Shunt revisions. The cause of hydrocephalus was significantly associated with Shunt survival for patients who had Shunt failure before the age of 17 years. Being pediatric at first Shunt revision, infection, proximal Shunt complication, and other causes were independently associated with multiple Shunt failures. Conclusion The findings of this retrospective study show that the long-term Ventriculoperitoneal Shunt survival remains low in adult transition patients with pediatric-onset hydrocephalus.
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spontaneous bowel perforation after Ventriculoperitoneal Shunt surgery case report and a review of 45 cases
Surgical Neurology, 2000Co-Authors: Satish Sathyanarayana, Esther Wylen, Mustafa K Baskaya, Anil NandaAbstract:BACKGROUND Ventriculoperitoneal Shunt surgery is the most widely used procedure in the treatment of hydrocephalus. However, this invasive procedure has been associated with several delayed abdominal complications. Perforation of the bowel is a very rare complication occurring in less than 0.1% of cases. Although infrequent, this delayed complication can be fatal if it goes unrecognized. CASE DESCRIPTION This report presents an adult patient who had undergone Ventriculoperitoneal Shunt surgery and later presented with rectal protrusion of the Shunt tube after asymptomatic perforation of the bowel wall. The Shunt was removed without complication and the patient remained asymptomatic. CONCLUSIONS Forty-five similar cases have been reported in the literature. The information provided within this report examines the case at hand, as well as provides an analysis of the literature as it relates to bowel perforation through symptomatic presentation, diagnosis, cultures, management with or without laparotomy, and outcome.
Anthony M Avellino - One of the best experts on this subject based on the ideXlab platform.
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transanal presentation of a distal Ventriculoperitoneal Shunt catheter management of bowel perforation without laparotomy
Surgical Neurology International, 2016Co-Authors: James W Bales, Ryan P Morton, Nathan Airhart, David R Flum, Anthony M AvellinoAbstract:Background Bowel perforation is a serious but rare complication after a Ventriculoperitoneal Shunt (VPS) procedure. Prior studies have reported spontaneous bowel perforation after VPS placement in adults of up to 0.07%. Transanal catheter protrusion is a potential presentation of VPS bowel perforation and places a patient at risk for both peritonitis and ventriculitis/meningitis via retrograde migration of bacteria. This delayed complication can be fatal if unrecognized, with a 15% risk of mortality secondary to ventriculitis, peritonitis, or sepsis. Case description We describe a unique case of a patient with distal VPS catheter protrusion from the anus whose bowel perforation did not cause clinical sequelae of infection. We were able to manage the patient without laparotomy. Conclusions A subset of patients can be managed without laparotomy and only with externalization of the ventricular Shunt with antibiotics until the cerebrospinal fluid cultures finalize without growth.
Gloria Caldito - One of the best experts on this subject based on the ideXlab platform.
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Ventriculoperitoneal Shunt surgery and the risk of Shunt infection in patients with hydrocephalus: long-term single institution experience.
World Neurosurgery, 2012Co-Authors: G. Kesava Reddy, Papireddy Bollam, Gloria CalditoAbstract:Objective Infection remains the most significant complication of Ventriculoperitoneal Shunt surgery and the reported rates of cerebrospinal fluid Shunt infection vary widely across studies in patients with hydrocephalus. The objective of this study is to review and evaluate the infections complicating Ventriculoperitoneal Shunt surgery in patients with hydrocephalus. Methods Patients who underwent Ventriculoperitoneal Shunt surgery for hydrocephalus between 1961 and 2010 were included. Medical charts, operative reports, imaging studies, and clinical follow-up evaluations were reviewed and analyzed retrospectively. Results A total of 1015 patients with hydrocephalus who underwent Ventriculoperitoneal Shunt surgery were included. The mean and median follow-up was 9.2 and 6.5 years, respectively. The median age of the patients at the time of Ventriculoperitoneal Shunt placement was 41.6 years. Pediatric patients ( P Conclusions Infection remains the most serious complication of Ventriculoperitoneal Shunt surgery. The findings of this retrospective study show that gender, age, and etiology of hydrocephalus significantly correlated independently with the incidence of infection. Prospective studies are needed to assess the observed associations between the risk factors and incidence of infection in hydrocephalus patients treated with Ventriculoperitoneal Shunt surgery.
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Ventriculoperitoneal Shunt surgery outcome in adult transition patients with pediatric onset hydrocephalus
Neurosurgery, 2012Co-Authors: Kesava G Reddy, Papireddy Bollam, Gloria Caldito, Bharat Guthikonda, Anil NandaAbstract:Background Ventriculoperitoneal Shunting remains the most widely used neurosurgical procedure for the management of hydrocephalus, albeit with many complications. Objective To review and assess the long-term clinical outcome of Ventriculoperitoneal Shunt surgery in adult transition patients with pediatric-onset hydrocephalus. Methods Patients 17 years or older who underwent Ventriculoperitoneal Shunt placement for hydrocephalus during their pediatric years (younger than 17 years) were included. Medical charts, operative reports, imaging studies, and clinical follow- up evaluations were reviewed and analyzed retrospectively. Results A total of 105 adult patients with pediatric-onset hydrocephalus were included. The median age of the patients was 25.9 years. The median age at the time of the initial Ventriculoperitoneal Shunt placement was 1.0 year. The median follow-up time for all patients was 17.7 years. The incidence of Shunt failure at 6 months was 15.2%, and the overall incidence of Shunt failure was 82.9%. Single Shunt revision occurred in 26.7% of the patients, and 56.2% had multiple Shunt revisions. The cause of hydrocephalus was significantly associated with Shunt survival for patients who had Shunt failure before the age of 17 years. Being pediatric at first Shunt revision, infection, proximal Shunt complication, and other causes were independently associated with multiple Shunt failures. Conclusion The findings of this retrospective study show that the long-term Ventriculoperitoneal Shunt survival remains low in adult transition patients with pediatric-onset hydrocephalus.
James W Bales - One of the best experts on this subject based on the ideXlab platform.
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transanal presentation of a distal Ventriculoperitoneal Shunt catheter management of bowel perforation without laparotomy
Surgical Neurology International, 2016Co-Authors: James W Bales, Ryan P Morton, Nathan Airhart, David R Flum, Anthony M AvellinoAbstract:Background Bowel perforation is a serious but rare complication after a Ventriculoperitoneal Shunt (VPS) procedure. Prior studies have reported spontaneous bowel perforation after VPS placement in adults of up to 0.07%. Transanal catheter protrusion is a potential presentation of VPS bowel perforation and places a patient at risk for both peritonitis and ventriculitis/meningitis via retrograde migration of bacteria. This delayed complication can be fatal if unrecognized, with a 15% risk of mortality secondary to ventriculitis, peritonitis, or sepsis. Case description We describe a unique case of a patient with distal VPS catheter protrusion from the anus whose bowel perforation did not cause clinical sequelae of infection. We were able to manage the patient without laparotomy. Conclusions A subset of patients can be managed without laparotomy and only with externalization of the ventricular Shunt with antibiotics until the cerebrospinal fluid cultures finalize without growth.
Patrick W Hanlo - One of the best experts on this subject based on the ideXlab platform.
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Ventriculoperitoneal Shunt occlusion due to spontaneous intraabdominal knot formation in the catheter case report
Journal of Neurosurgery, 2006Co-Authors: Peter A Woerdeman, Patrick W HanloAbstract:A male infant was born full term with a prenatally diagnosed lumbosacral meningomyelocele and dilated ventricles that required Ventriculoperitoneal Shunt treatment. Following Shunt insertion, a dysfunction occurred and operative exploration of the distal catheter revealed a knot formation resulting in occlusion of the Shunt lumen. After the knot was untangled, the symptoms of increased intracranial pressure diminished. The authors stress that any possible cause of mechanical Shunt complication should be taken into account when Shunt malfunction is expected.
