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.
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The three causal mechanisms advanced to explain the development of postoperative hydrothorax have been extensively reviewed by both Doh, et al. During shunt surgery the peritoneal surfaces were observed to be thickened and the intestinal loops were matted together, suggesting that the diffusely present thick adhesions created a poor milieu for CSF absorption.
Three weeks after discharge the infant was readmitted to the hospital because of labored, tachypneic breathing, and frequent oxygen desaturation accompanied by bradycardia. The scarring caused a significantly decreased peritoneal absorptive ability and decreased peritoneal surface area and abdominal cavity voume.
Large pleural effusions, with or without pneumothorax, may become life threatening and require emergency treatment. Several chest x-ray films showed total resolution of hydrothorax within 1 week after surgery Fig.
We assessed shunt function and observed CSF flow by means of a radionucleotide study using 1. Pediatria Medica e Chirurgica15 2 Anteroposterior chest x-ray film obtained 1 week after shunt revision demonstrating complete resolution of hydrothorax and expansion of the lungs. Owing to their relative rare incidence and the aspecificity of their clinical presentation, this last type of complication has received a minor consideration.
Hydrothorax is poorly tolerated in the very young and can lead to hypoxia and compensated respiratory acidosis, as we observed in our infant patient. In this instance a pneumothorax frequently accompanies the hydrothorax. Serial dynamic images revealed radioactive contrast material throughout the entire shunt without evidence of obstruction or isotope leakage. At 30 minutes after the start of ventricoko radioactivity appeared in the thoracic region Fig.
This forced CSF to flow preferentially in a superior direction toward the diaphragmatic lymphatic structures, where it was drawn by negative intrathoracic pressure into the pleural cavity for absorption. Abstract The surgical treatment of hydrocephalus has been greatly improved by the techniques of ventriculo-peritoneal shunting. Peritoneals he most common complications after shunt placement for cerebrospinal fluid Cerivazione drainage to treat hydrocephalus are shunt infection and obstruction.
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.
The pathways of the flow of contrast material within peritonealee peritoneal cavity were defined by Autio. Ospedale Pediatrico Bambino Gesu.
Link to citation list in Scopus. 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. The salient anatomical and physiological features of the peritoneal cavity have been summarized by Rotstein and Simmons. Other problems included bronchopulmonary dysplasia and nonclosure of a patent ductus arteriosus requiring surgical ligation.
She subsequently developed Grade Peritnoeale ventricular hemorrhage. Examination Three weeks after discharge the infant was readmitted to the hospital because of labored, tachypneic breathing, and frequent oxygen desaturation accompanied by bradycardia.
Arterial blood gas and serum electrolyte testing showed hypoxia and compensated respiratory acidosis. A 99m Tc-DTPA radionucleotide scan showing isotope flow into the chest cavity within 30 minutes and minimal presence of isotope in the peritoneal cavity.
Translated title of the contribution Postprandial and postural dyspnea: Her abdomen was soft, nontender, and not distended. A VP shunt was placed to treat communicating hydrocephalus after the necrotizing en-terocolitis had completely resolved, when there were no further gastrointestinal complications and after oral feeding had been well tolerated for several days.
Pediatria Medica e ChirurgicaVol. Second, the peritoneal tube can migrate through the diaphragm into the chest on its own or after an abdominal inflammatory process occurs. During each shunt surgery dense adhesions were observed in the abdominal contents and peritoneal cavity. Case Report History This 4-month-old peritondale had been born at 24 weeks of gestation after premature rupture of the amniotic membranes.
Shunt cerebrale – Wikipedia
Respiratory distress as a presenting symptom of VP shunt malfunction is unusual, and as illustrated in our case, should be considered in the differential diagnosis of shunt malfunction. Postprandial and postural dyspnea: AU – Velardi, F.
Our experience teaches that hydrothorax after ventriculoperitoneal shunt placement in a premature infant may arise as an derivaxione, postoperative complication of VP shunt surgery that is caused by preferential transdiaphragmatic flow of CSF into the pleural cavity from poor abdominal absorptive capacity of CSF.
The patient had an uneventful perironeale recovery with complete resolution of respiratory difficulties. AU – Pancani, S. 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.