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Clinical peritonitis from allergy to silicone ventriculoperitoneal shunt

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Abstract

Silicones are inorganic compounds that have been used for the purpose of shunting ventricular fluid since the mid-20th century [1]. Complications of ventriculoperitoneal shunts have rarely been attributed to silicone allergy, with only a handful of cases reported in literature. The classic presentation of allergy to silicone ventriculoperitoneal shunt, i.e., abdominal pain with recurrent skin breakdown along the shunt tract, is nonspecific and difficult to distinguish clinically from other causes of shunt-related symptoms. It can be diagnosed by detection of antisilicone antibodies and is treated with removal of the shunt and replacement, if needed, with a polyurethane shunt system. We report the first case of suspected silicone allergy presenting as clinical peritonitis without overt colonic perforation.

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Authors and Affiliations

  1. Department of General Internal Medicine, University of Pittsburgh Medical Center, 200 Lothrop St., Room N 715, Pittsburgh, PA, 15213, USA

    Michael Kurin & Chandraprakash Umapathy

  2. Division of Gastrointestinal Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Kenneth Lee

  3. Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Paul Gardner

  4. Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Merritt Fajt

  5. Division of Gastroenterology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Kenneth Fasanella

Authors
  1. Michael Kurin
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  2. Kenneth Lee
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  3. Paul Gardner
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  4. Merritt Fajt
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  5. Chandraprakash Umapathy
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  6. Kenneth Fasanella
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Contributions

M.K. wrote and edited the manuscript, K.L., P.G., M.F., C.U., and K.F. all participated in the patient’s care and provided significant edits to the manuscript.

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Correspondence to Michael Kurin.

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This article required no funding, and to our knowledge none of the authors involved have any conflict of interest.

Human Rights

All of the procedures were performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from the patient for publication of this case.

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Article Guarantor: K. Fasanella.

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Kurin, M., Lee, K., Gardner, P. et al. Clinical peritonitis from allergy to silicone ventriculoperitoneal shunt. Clin J Gastroenterol 10, 229–231 (2017). https://doi.org/10.1007/s12328-017-0729-0

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  • DOI: https://doi.org/10.1007/s12328-017-0729-0

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