Le pseudo kyste abdominal: une complication de la dérivation ventricule péritonéale à propos d'un cas / The abdominal pseudocyst: a complication of ventriculoperitoneal bypass about a case

Le pseudokyste abdominal est une complication rare pouvant survenir chez les sujets porteurs d'une dérivation ventriculo-péritonéale (DVP). Nous rapportons le cas d'un adolescent de 11 ans, chez qui une DVP a été réalisée pour une hydrocéphalie congénitale. Il présentait une distension abdominale progressive sans notion de troubles de transit. L'imagerie (échographie, urosacnner) a permis de mettre en évidence un épanchement péritonéal de grande abondance organisé, à paroi fine et régulière, exerçant un effet de masse sur la vessie et les uretères, responsable d'une urétérohydronéphrose bilatérale. Le bout distal du cathéter de DVP a été visualisé dans la collection

The abdominal pseudocyst is a rare complication that can occur in subjects with a ventriculoperitoneal drain (VPD). We report the case of an 11-year-old adolescent with congenital hydrocephalus antecedent, for whom a ventriculoperitoneal shunt was made. He presented a progressive abdominal distension without notion of transit disorders. Abdominal ultrasound and uroscanner revealed an organized peritoneal effusion of great abundance, thin and regular wall, exerting a mass effect on the bladder and the ureters responsible for bilateral uretero-hydronephrosis. Above all, it has made it possible to individualize the distal ventriculo-peritoneal bypass catheter projecting in the effusion

Ventriculo-Peritoneal Shunt Infections in Infants and Children

Objective: To determine the rate and the type of ventriculoperitoneal (VP) shunt infections in infants and children admitted to King Fahad Hofuf hospital of Al-Ahsaa area at the Eastern Province of Saudi Arabia. Methods: From mid 2003 to end of 2006; VP shunt infection episodes were reviewed. Once infection was suspected; a cerebro- spinal fluid (CSF) sample was taken and empirical antibiotics were recommended. Once infection was confirmed; VP shunt was removed and external ventricular drainage (EVD) was inserted until CSF became sterile after which a new shunt was inserted. Results : 25.9 of patients with VP shunts had infections which represents 29.3of the procedures. 40 of infected patients had recurrent episodes. 59.1 of infections occurred throughout the first two months following insertion. Single pathogen was isolated in each episode. Pseudomonas auerginosa represented 50 of isolated pathogens compared with 18.2 with Staphylococcus epidermidis. Conclusions There is a high incidence of VP shunt infections in King Fahad Hofuf hospital when compared with other international centres. Gram negative organisms are the most common cause of the infection

Alterations in Family Psychodynamics Following a Ventriculoperitoneal Shunt Placement

Background: The emotional stress of a young couple whose child has hydrocephalus can be immense. When a shunt has to be inserted without the parents being thoroughly educated on every aspect of the procedure; the situation can be overwhelming and significant psychosocial problems can develop. Aim: To report the case of behavioural change in the father of a hydrocephalic child who underwent shunt placement and the threat of family collapse due to misconceptions about the procedure. Method : The records of the child; including history; examination; investigations and treatment were evaluated. The mother was extensively interviewed during follow-up out-patient visits. Relevant literature on shunt complications was reviewed. Result: Following shunt insertion for hydrocephalus in an only child of a young couple born after 3 years of marriage; the father started withdrawing from his family and gradually began to manifest symptoms of depressive illness. Recommendations: The parents of every child scheduled to have shunt insertion should be properly counselled together on all aspects of the procedure preoperatively. This would help ensure that any consent given is on the basis of their mutual understanding and acceptance of the situation. Where problems are anticipated; it might be necessary to take pre-emptive measures to forestall their occurrence

Alterations in family psychodynamics following a ventriculoperitoneal shunt placement

Background: The emotional stress of a young couple whose child has hydrocephalus can be immense. When a shunt has to be inserted without the parents being thoroughly educated on every aspect of the procedure; the situation can be overwhelming and significant psychosocial problems can develop. Aim: To report the case of behavioural change in the father of a hydrocephalic child who underwent shunt placement and the threat of family collapse due to misconceptions about the procedure. Method: The records of the child; including history; examination; investigations and treatment were evaluated. The mother was extensively interviewed during follow-up out-patient visits. Relevant literature on shunt complications was reviewed. Result: Following shunt insertion for hydrocephalus in an only child of a young couple born after 3 years of marriage; the father started withdrawing from his family and gradually began to manifest symptoms of depressive illness. Recommendations: The parents of every child scheduled to have shunt insertion should be properly counselled together on all aspects of the procedure preoperatively. This would help ensure that any consent given is on the basis of their mutual understanding and acceptance of the situation. Where problems are anticipated; it might be necessary to take pre-emptive measures to forestall their occurrence

Hématome sous dural, complication du traitement chirurgical des hydrocéphalies. Notre expérience à Dakar

Introduction : L'hématome sous dural est une complication observée lors du traitement chirurgical de l'hydrocéphalie. Avant l'avènement de la tomodensitométrie à Dakar, une incidence de 0,8 % était trouvée. L'objectif de notre travail est de réévaluer cette incidence à la lumière de cet examen et de déterminer les divers facteurs étiologiques. Patients et Méthode : Nos patients ont été opérés par dérivation ventriculo-péritonéale et sont âgés de 8 à 30 ans au moment du diagnostic. Quatre sont de sexe féminin. Le signe le plus fréquent est l'hypertension intra-cranienne. La tomodensitométrie a établi le diagnostic dans tous les cas. Elle montrait dans 4 cas, un hématome unilatéral et dans deux cas, une forme bilatérale. D'importantes calcifications sont retrouvées dans deux cas. Cinq patients ont été opérés et nous notons deux décès. Les valves utilisées sont à débit de drainage fixe. Résultat : Il existe une augmentation de l'incidence par rapport à notre première série datant de 12 ans. Par rapport aux autres systèmes de drainage, nous ne notons pas de différence significative. Aucun facteur étiologique déterminant n'est retrouvé. Conclusion Cette complication pouvant pauci-symptomatique, la réalisation d'examens tomodensitométriques systématiques permettrait de constater une plus grande fréquence de cette complication