Avoiding the pocket: A case report of coiling of distal shunt catheter into subcutaneous pocket.
Avoiding the pocket: A case report of coiling of distal shunt catheter into subcutaneous pocket.
复制标题
避免口袋：远端分流导管卷入皮下口袋的病例报告。
DOI：
10.1016/j.ijscr.2017.09.036
复制
发表时间：
2017
影响因子：
0.6
通讯作者：
Harris,CarolynAnne
中科院分区：
文献类型：
--
作者：
Garling,RichardJustin;Sood,Sandeep;Harris,CarolynAnne
脑积水是神经外科最常见的疾病之一，脑室分流是主要的手术干预措施，85%的患者在10年内出现故障。在此，我们报告一个12岁的女孩，她有迷走神经刺激器（VNS）和心室分流的病史，最近在一家外医院从心室心房（VA）分流改为心室腹膜（VP）分流。患者表现为新的左胸隆起、恶心、呕吐和癫痫发作。影像学显示患者的远端分流导管已完全移位并盘绕到VNS皮下袋内。随后，患者的远端分流导管外化，随后内化回VA分流器。先前手术的潜在间隙，如VNS，可导致远端分流导管盘绕。在本例中，卷曲的远端分流导管导致脑积水和患者的症状。结论对有手术史的患者，尤其是有皮下植入的患者，应及时识别，避免远端分流管穿过这些潜在间隙。
IntroductionHydrocephalus is one of the most common disorders of neurosurgery and ventricular shunting, the primary surgical intervention, malfunctions in 85% of patients by 10 years.Presentation of caseHere we present a case of a 12-year-old girl with history of a vagal nerve stimulator (VNS) and ventricular shunt, most recently revised from ventriculoatrial (VA) to ventriculoperitoneal (VP) shunt at an outside hospital. The patient presented with a new left chest bulge, nausea, emesis, and seizures. Imaging revealed the patient’s distal shunt catheter to have completely migrated and coiled into the VNS subcutaneous pocket. Subsequently, the patient’s distal shunt catheter was externalized, and later internalized back to a VA shunt.DiscussionPotential spaces from previous surgeries such as VNS can lead to coiling of distal shunt catheters. In this case, the coiled distal shunt catheter led to hydrocephalus and the patient’s presenting symptoms.ConclusionIt is imperative to recognize patients with previous surgeries, especially those involving subcutaneous implants and to avoid passing of distal shunt catheters through these potential spaces.
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