complicanza piu frequente e temibile delle derivazioni ventricolo-peritoneali. sterna di derivazione infettato, rappresentano le complicanze piu frequenti e. Iannelli, A., Puca, A., Calisti, A. () ‘Idrocele edernia inguinale dopo derivazione ventricolo peritoneale in età pediatrica. Pediatria del Medico Chirurgica. Dispnea postprandiale e da posizione: segno clinico di pseudocisti intraperitoneale in pazienti con idrocefalo e derivazione ventricolo-peritoneale. Pediatria.

Author: Nikoshakar Tashura
Country: Mexico
Language: English (Spanish)
Genre: Finance
Published (Last): 4 October 2016
Pages: 478
PDF File Size: 1.77 Mb
ePub File Size: 1.3 Mb
ISBN: 180-5-26222-842-2
Downloads: 1558
Price: Free* [*Free Regsitration Required]
Uploader: JoJoktilar

Flow into the pelvis and paracolic spaces is likely the result of the effect of gravity when prone and upright positions are assumed.

Several complications may however occur following these operative procedures. The salient anatomical and physiological features of the peritoneal cavity have been summarized by Rotstein and Simmons. Intraperitoneal pseudocysts are also a known complication of ventriculo-peritoneal shunts. Large pleural effusions, with or without pneumothorax, may become life threatening and require emergency treatment.

Discussion This case is unique because hydrothorax occurred as a result of preferential transdiaphragmatic flow of CSF into the pleural cavity in the absence of ascites. This 4-month-old girl had been born at 24 weeks of gestation after premature rupture of the amniotic membranes.

The scarring caused a significantly decreased peritoneal absorptive ability and decreased peritoneal surface area and abdominal cavity voume. Studies in patients undergoing dialysis have elucidated peritoneal fluid exchange rates and have shown that water and solutes cross the peritoneum in a passive, bidirectional flow. Respiratory exhalation produces passive stretching of the diaphragm with rapid influx of fluid through the stomas into the lacunae.

Access to Document Link to publication in Scopus. AU – Velardi, F. N2 – The surgical treatment of hydrocephalus ventricllo been greatly improved by the techniques of ventriculo-peritoneal derviazione. We assessed shunt function and observed CSF flow by means of a radionucleotide study using 1. Subsequent images demonstrated increased accumulation in the oeritoneale region, and an intense area of radioactivity next to the diaphragm, consistent with communication of CSF between the abdominal and thoracic cavities Fig.


We postulate that in our patient diffuse peritoneal surface scarring resulting from necrotizing enterocolitis created a milieu that interfered with the normal mechanisms of fluid and solute absorption.

Shunt cerebrale – Wikipedia

Translated title of the contribution Postprandial and postural dyspnea: T he most common complications after shunt placement for cerebrospinal fluid CSF drainage to treat hydrocephalus are serivazione infection and obstruction. Other problems included bronchopulmonary dysplasia and nonclosure of a patent ductus arteriosus requiring surgical ligation.

Hydrothorax is poorly tolerated periyoneale the very young and can lead to hypoxia and compensated respiratory acidosis, as we observed in our infant patient. AB – The surgical treatment of hydrocephalus has been greatly improved by the techniques of ventriculo-peritoneal shunting. Link to citation list in Scopus. Operation Because the workup showed absence of shunt and pleural fluid infections and preferential flow of CSF from the peritoneal to the pleural cavity, the existing VP shunt was converted to a ventriculoatrial shunt.

This case is unique because hydrothorax occurred as a result of preferential transdiaphragmatic flow of CSF into the pleural cavity in the absence of ascites.

This case is different from others reported in the literature because CSF ascites was not present, there was no shunt migration or inadvertent chest penetration during shunt surgery, and a 99m Tc-diethylenetriamine pentaacetic acid DTPA radionucleotide study confirmed the presence of preferential transdiaphragmatic CSF flow.

Delayed images demonstrating further isotope activity in the pleural cavity with a preferential flow pattern of CSF toward the superior abdominal region, diaphragm, and into the chest cavity.


In instances of intrathoracic shunt migration or pleural cavity shunt penetration, repositioning of the shunt from the thoracic cavity into the abdomen corrects the problem.

During this interval symptomatic hydrocephalus was treated by withdrawing CSF via intermittent lumbar and ventricular punctures.

Shunt cerebrale

Particulate matter, unlike fluids and solutes, is cleared via stomas between specialized mesothelial cells that overlie the lymphatic channels present on the diaphragmatic peritoneal surface.

Second, the peritoneal tube can migrate through the diaphragm into the chest on its own or after an abdominal inflammatory process occurs. AU – Palma, P. Many observations have been dedicated to these pathological findings, due to their frequency and the relatively easy diagnosis.

Abstract The surgical treatment of hydrocephalus has been greatly improved by the techniques of ventriculo-peritoneal shunting.

Most of the complications are related to the distal end of the shunt device and include obstruction of intraperitoneal catheter, development of inguinal hernia or hydrocele, perforation of viscera.

The tube migrates through a preexisting hiatus, or through the anterior foramen of Morgagni or posterior foramen of Bochdalek, the two congenital hiatuses where the diaphragmatic musculature is thinnest along its fibroareolar sternocostal and lumbocostal margins.

Postoperative Course The patient had an uneventful postoperative recovery with complete resolution of respiratory difficulties.

In addition, to our knowledge no 99m Tc-DTPA radioactive scan demonstrating preferential transdiaphragmatic CSF flow into the pleural cavity has been described in the literature.