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Acta Neurochir (Wien) (2008) 150: 829831 DOI 10.1007/s00701-008-1616-8Printed in The Netherlands
Case ReportPersistent lower abdominal pain induced by long peritoneal shunt catheter
P. R. Chen1, R. F. Spetzler2
1 Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Medical School at Houston, Houston, Texas
2 Division of Neurosurgery, Barrow Neurological Institute, St. Josephs Hospital and Medical Center, Phoenix, Arizona
Received 20 November 2007; Accepted 28 April 2008; Published online 23 June 2008 # Springer-Verlag 2008
Summary
Persistent abdominal pain directly induced by a perito-neal catheter of a ventriculoperitoneal shunt, which is associated with no other complications such as bowel perforation, pseudocyst or infection, has not been previously reported. A 65-year-old woman with hydrocephalus developed persistent lower abdominal pain radiating to the perineal area after shunt insertion. Radiography suggested that the distal end of a peritoneal catheter was located in a cul-de-sac of the pelvis. Otherwise, all studies were negative for shunt infection, uid collection, or other abdominal and pelvic events. The patients pain resolved completely after surgery in which the peritoneal catheter was shortened. In the presence of unexplained, persistent lower abdominal pain after shunt placement, the need to shorten the peritoneal catheter should be considered.
Keywords: Ventriculoperitoneal shunt; peritoneal catheter; abdominal and pelvic pain.
Thousands of ventriculoperitoneal (VP) shunts have been implanted in patients with hydrocephalus worldwide. There have been no reports of abdominal and pelvic pain directly induced by a VP shunt otherwise associated with no complications such as bowel perforation, pseudocyst, or infection. We, however, observed a case with persistent lower abdominal and pelvic pain
caused by irritation of the peritoneal catheter by a VP shunt.
Illustrative case
A 65-year-old Caucasian woman was admitted to the hospital with a Fisher grade III and Hunt=Hess...