Post-shunt ascites in infants with optic chiasmal hypothalamic astrocytoma: role of ventricular gallbladder shunt
Tóm tắt
We report a series of infants with optic chiasmal hypothalamic astrocytomas (OCHAs) who developed abdominal ascites following ventriculo-peritoneal (VP) shunting. The mechanism of ascites development among these patients with OCHA remains speculative and unclear. We treated four infants with hypothalamic tumors who were shunted for hydrocephalus using standard VP shunts and who subsequently experienced symptomatic ascites. In three patients the gallbladder proved an effective alternative site for shunting prior to conversion to other sites, and in one patient the gallbladder shunt remains functional and revision-free. Several aspects of the gallbladder as a reservoir for CSF make this approach appealing. Ventricular gallbladder shunting provided an effective (at least temporarily) receptacle for CSF in these patients.
Tài liệu tham khảo
Adegbite AB, Khan M (1982) Role of protein content in CSF ascites following ventriculoperitoneal shunting. J Neurosurg 57:423–425
Barami K, Sood S, Ham S, Canady A (1998) Chemical meningitis from bile reflux in a lumbar-gallbladder shunt. Pediatr Neurosurg 29:328–330
Bernstein RA, Hsueh W (1985) Ventriculocholecystic shunt: a mortality report. Surg Neurol 23:31–37
Gil Z, Beni-Adani L, Siomin V, Nagar H, Dvir R, Constantini S (2001) Ascites following ventriculoperitoneal shunting in children with chiasmatic-hypothalamic gliomas. Childs Nerv Syst 17:395–398
Ketoff J, Klein R, Maukkassa K (1997) Ventricular cholecystic shunts in children. J Pediatr Surg 32:181–183
Keucher TR, Mealey J (1979) Long term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus. J Neurosurg 50:179–186
Novelli PM, Reigel DH (1997) A closer look at the ventriculo-gallbladder shunt for the treatment of hydrocephalus. Pediatr Surg 26:197–199
Shuper A, Horev G, Michovitz S, Korenreich L, Zaizov R, Cohen IJ (1997) Optic chiasm glioma, electrolyte abnormalities, nonobstructive hydrocephalus and ascites. Med Pediatr Oncol 29:33–35
Smith GW, Moretz WH, Pritchard WL (1958) Ventriculo-biliary shunt, a new treatment for hydrocephalus. Surg Forum 9:701–705
Stringel G, Turner M, Crase T (1993) Ventriculo-gallbladder shunts in children. Childs Nerv Syst 9:330–333
Vernet O, Campiche R, de Tribolet N (1995) Long-term results after ventriculo-atrial shunting in children. Childs Nerv Syst 11:176–179
West K, Turner MK, Vane DW, Boaz J, Kalsbeck J, Grosfeld JL (1987) Ventricular gallbladder shunts: an alternative procedure in hydrocephalus. J Pediatr Surg 22:609–612
West GA, Berger MS, Geyer JR (1994) Childhood optic pathway tumors associated with ascites following ventriculoperitoneal shunt placement. Pediatr Neurosurg 21:254–259
Yasuda T, Tomita T, McLone DG, Donovan M (2002) Cerebrospinal fluid (CSF) output measurement through external ventricular drainage in one hundred infants and children: correlation with CSF production. Pediatr Neurosurg 36:22–28
Yount RA, Glazier MC, Mealey J, Kalsbeck JE (1984) Cerebrospinal fluid ascites complicating ventriculoperitoneal shunting. J Neurosurg 61:180–183