Child's Nervous System

, Volume 22, Issue 10, pp 1225–1230 | Cite as

Nonfunctional abdominal complications of the distal catheter on the treatment of hydrocephalus: an inflammatory hypothesis?

Experience with six cases
  • Humberto Belem de Aquino
  • Edmur Franco Carelli
  • Antonio Guilherme Borges Neto
  • Carlos Umberto Pereira
Review Paper



The peritoneal cavity is the most common site of cerebrospinal fluid absorption in hydrocephalus treatment. Many distal catheter complications are the result of this type of treatment, and these have been extensively described in the neurosurgical literature.

Materials and methods

In our study, six cases of distal catheter migration with visceral perforation and/or extrusion are presented: three through the umbilicus, two through the scrotum, and one through the anus. An extensive review of the literature was performed.


The studies of peritoneal dialysis models for the treatment of chronic renal failure patients provide important data about solute absorption in the peritoneal cavity and reactivity of the peritoneal membrane.


This model, when compared to distal catheter complications on a ventriculoperitoneal (VP) shunt, presents similarities that could help understand the mechanism of the nonfunctional complications of the distal VP catheter (complication with functional shunt), providing valuable data to support an inflammatory mechanism.


Hydrocephalus Ventriculoperitoneal shunt system Inflammation Abdominal complications Distal catheter Peritoneal dialysis 


  1. 1.
    Abu-Dalu K, Pode D, Hadani M, Sahar A (1987) Colonic complications of ventriculoperitoneal shunts. Neurosurgery 13(2):167–169CrossRefGoogle Scholar
  2. 2.
    Adegbite AB, Khan M (1982) Role of protein content in CSF ascitis following ventriculoperitoneal shunting. J Neurosurg 57:423–425PubMedGoogle Scholar
  3. 3.
    Adeloye A (1973) Spontaneous extrusion of the abdominal tube through the umbilicus complicating peritoneal shunt for hydrocephalus. J Neurosurg 38:758–760PubMedGoogle Scholar
  4. 4.
    Alexander SR (1994) Peritoneal dialysis. In: Holliday MA, Barratt TM, Avner ED (eds) Pediatric nephrology, 3rd edn. Williams & Wilkins, Baltimore, pp 1339–1353Google Scholar
  5. 5.
    Alonso-Vanegas M, Alvarez JL, Delgado L, Mendizábal R, Jiménez JL, Sanches-Cabrera JM (1994) Gastric perforation due to ventriculoperitoneal shunt. Pediatr Neurosurg 21:192–194PubMedGoogle Scholar
  6. 6.
    Antunes ACM, Ribeiro TR (1975) Spontaneous umbilical fístula from ventriculoperitoneal shunt drainage. J Neurosurg 43:481–482PubMedGoogle Scholar
  7. 7.
    Aronyk KE (1993) The history and classification of hydrocephalus. Neurosurg Clin N Am 4(4):599–609PubMedGoogle Scholar
  8. 8.
    Bouch AL, Hermelin E, Sainte-Rose C, Sgouros S (1998) Mechanical dysfunction of ventriculoperitoneal shunts caused by calcification of silicone rubber catheter. J Neurosurg 88:975–982PubMedCrossRefGoogle Scholar
  9. 9.
    Burkart JM (2002) Peritoneal dialysis. In: Brenner BM, Rectors FC Jr (eds) The kidney, vol 2, 5th edn. Saunders, Philadelphia, pp 2454–2517Google Scholar
  10. 10.
    Cuka GM, Helbusch LC (1995) Fractures of the peritoneal catheter of cerebrospinal fluid shunts. Pediatr Neurosurg 22:101–103PubMedGoogle Scholar
  11. 11.
    Del Bigio MR (1998) Biological reaction to cerebrospinal fluid shunts devices: a review of the cellular pathology. Neurosurgery 42(2):319–325CrossRefPubMedGoogle Scholar
  12. 12.
    Drake JM, Sainte-Rose C (1995) The shunt book. Blackwell, Cambridge, pp 123–192Google Scholar
  13. 13.
    Elisevich K, Mattar AG, Cheeseman F (1994) Biodegradation of distal shunt catheter. Pediatr Neurosurg 21:71–76PubMedCrossRefGoogle Scholar
  14. 14.
    Er°ahin Y, Mutluer S, Tekeli G (1996) Abdominal cerebrospinal fluid pseudocysts. Childs Nerv Syst 12:755–758PubMedGoogle Scholar
  15. 15.
    Fermin S, Fernández-Guerra RA, Sureda PJ (1996) Extrusion of peritoneal catheter through the mouth. Childs Nerv Syst 12:553–555CrossRefPubMedGoogle Scholar
  16. 16.
    Gil Z, Beni-Adani L, Siomin V, Nagar H, Dvir R, Constantini S (2001) Ascitis following ventriculoperitoneal shunting in children with chiasma-hypothalamic glioma. Childs Nerv Syst 17:395–398CrossRefPubMedGoogle Scholar
  17. 17.
    Giuffrè R, Di Lorenzo N (1975) Two unusual complications of ventriculo-peritoneal shunt in the same infant. Surg Neurol 3:23–24PubMedGoogle Scholar
  18. 18.
    Gelabert González M (1987) Extrusion of peritoneal catheter through the anus. Childs Nerv Syst 3:183–184CrossRefPubMedGoogle Scholar
  19. 19.
    Guevara JA, La Torre J, Denoya CD, Zúccaro G (1981) Microscopic studies in shunts for hydrocephalus. Childs Brain 8:193–284CrossRefGoogle Scholar
  20. 20.
    Guevara JA, Zúccaro G, Trevisán A, Denoya CD (1987) Bacterial adhesion to cerebrospinal fluid shunts. J Neurosurg 67:438–445PubMedGoogle Scholar
  21. 21.
    Johnson MC, Maxwell MS (1995) Delayed intrapleural migration of a ventriculo-peritoneal shunt. Childs Nerv Syst 11:348–350CrossRefPubMedGoogle Scholar
  22. 22.
    Jörres A, Ludat K, Sander K, Dunkel K, Lorenz F, Keck H, Frei U, Gahl GM (1996) The peritoneal fibroblast and the control of peritoneal inflammation. Kidney Int 50(Suppl 56):S22–S27Google Scholar
  23. 23.
    Kalousdian S, Karlan MS, Willians MA (1998) Silicone elastomer cerebrospinal fluid shunt systems. Neurosurgery 42(4):887–892CrossRefPubMedGoogle Scholar
  24. 24.
    Krediet RT (1999) The peritoneal membrane in chronic peritoneal dialysis. Kidney Int 55:341–356CrossRefPubMedGoogle Scholar
  25. 25.
    Kwork CK, Yes CP, Wen HL (1989) Bilateral scrotal migration catheter: a rare complication of ventriculoperitoneal shunt. Surg Neurol 31:330–331CrossRefPubMedGoogle Scholar
  26. 26.
    Lortat-Jacob S et al (1984) Complications abdominals des shunts ventriculo-péritoneaux chez l’enfant: 65 observations. Chir Pediatr 25:17–21PubMedGoogle Scholar
  27. 27.
    Martin LM, Donaldson-Hugh ME, Cameron MM (1997) Cerebrospinal fluid hydrothorax caused by transdiaphragmatic migration of a ventriculo-peritoneal catheter through the foramen of Bochdalek. Childs Nerv Syst 13:282–284CrossRefPubMedGoogle Scholar
  28. 28.
    McAulay D, Dick AC, Paterson A (2001) Peritoneography in the assessment of peritoneal cerebrospinal fluid absorption. Neurosurgery 49(5):1267–1269CrossRefPubMedGoogle Scholar
  29. 29.
    Mozingo JR, Cauthen JC (1974) Vaginal perforation by a Raimondi peritoneal catheter in a adult. Surg Neurol 2:195–196PubMedGoogle Scholar
  30. 30.
    Nagulic M, Djordjevic M, Samardzie M (1996) Peritoneo-vulvar catheter extrusion after shunt operation. Childs Nerv Syst 12(4):222–223CrossRefPubMedGoogle Scholar
  31. 31.
    Nolph KD (1991) Peritoneal dialysis. In: Brenner BM, Rector FC Jr (eds) The kidney, vol 2, 4th edn. Saunders, Philadelphia, pp 2299–2335Google Scholar
  32. 32.
    Ramani PS (1974) Extrusion of abdominal catheter of ventriculoperitoneal shunt into the scrotum. J Neurosurg 40:772–773PubMedGoogle Scholar
  33. 33.
    Rubin RC, Ghatak NR Visudhipan P (1972) Asymptomatic perforated viscus and gram-negative ventriculitis as a complication of valve-regulated ventriculoperitoneal shunts. J Neurosurg 37:616–618PubMedCrossRefGoogle Scholar
  34. 34.
    Salomão JF, Leibinger RD (1999) Abdominal pseudocysts complicating CSF shunting in infant and children: report of 18 cases. Pediatr Neurosurg 31:274–278CrossRefPubMedGoogle Scholar
  35. 35.
    Schulhof LA, Worth M, Kalsbeck JE (1975) Bowel perforation due to peritoneal shunt: a report of seven cases and review of the literature. Surg Neurol 3:265–269PubMedGoogle Scholar
  36. 36.
    Snow RB, Lavyne MH, Fraser RAR (1986) Colonic perforation by ventriculoperitoneal shunts. Surg Neurol 25:173–177CrossRefPubMedGoogle Scholar
  37. 37.
    Wilson CB, Bertan V (1966) Perforation of the bowel complicating peritoneal shunt for hydrocephalus. Am Surg 32(9):601–603PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Humberto Belem de Aquino
    • 1
    • 2
    • 4
  • Edmur Franco Carelli
    • 1
  • Antonio Guilherme Borges Neto
    • 1
  • Carlos Umberto Pereira
    • 3
  1. 1.Neurology Department and NeurosurgeryService of State University of Campinas (UNICAMP)Campinas CityBrazil
  2. 2.Neurosurgery Service of the Hospital Municipal Dr. José de Carvalho Florence,São José dos Campos CityBrazil
  3. 3.Neurosurgery Professor of Sergipe Federal UniversityAracaju CityBrazil
  4. 4.Rua Jaime SpinelliCaçapava CityBrazil

Personalised recommendations