Abstract
Background
Tuberculosis is still a killer disease and a nightmare in developing countries. Post-tubercular hydrocephalus remains one of the most severe complications, with many diversion procedure methods. How common is the occurrence of co-morbid post tubercular hydrocephalus with tubercular peritonitis is still not known. This is a frustrating cause of repeated shunt complications and revisions.
Methods
We discuss the management of two cases that were the cause of nearly 50 % of our shunt revisions due to the comorbidities of post-tubercular hydrocephalus and tubercular adhesive peritonitis. We performed the ventriculocholecysto (VC) shunt. This procedure diverts CSF from the ventricular system to the gall bladder.
Results
The two children are disease free and did not require a revision in the 3.4-year follow-up period.
Conclusion
The VC shunt is a simple procedure. It improved the quality of life of these children who otherwise would have had a very morbid period during shunt revisions and the active disease. These children did not require further revisions and can grow normally.
This is a preview of subscription content, log in via an institution to check access.
References
Agrawal D, Gupta A, Mehta VS (2005) Role of shunt surgery in pediatric tubercular meningitis with hydrocephalus. Indian Pediatr 42:245–250
Behrendt H, Nau HE (1987) Ventriculo-renal shunt in the therapy of hydrocephalus. Urol A 26(6):331–333
Bhagwati SN (1971) Ventriculoatrial shunt in tuberculous meningitis with hydrocephalus. J Neurosurg 35:309–313
Bhagwati SN, Mehta N, Shah S (2010) Use of third ventriculostomy in hydrocephalus of tubercular origin. Childs Nerv Syst 26(12):1675–1682
Figaji AA, Fieggen AG, Peter JC (2003) Endoscopic third ventriculoscopy in tuberculous meningitis. Childs Nerv Syst 19:217–225
Husain M, Jha DK, Rastogi M, Husain N, Gupta RK (2005) Role of neuroendoscopy in the management of patients with tuberculous meningitis hydrocephalus. Neurosurg Rev 28:278–283
Jonathan A, Rajshekhar V (2005) Endoscopic third ventriculostomy for chronic hydrocephalus after tuberculous meningitis. Surg Neurol 63:32–34, discussion 34–35
Lamprecht D, Schoman J, Donald P, Hartzenberg H (2001) Venriculoperitoneal shunting in childhood tuberculous meningitis. Br J Neurosurg 15:119–125
Murray HW, Bransetter R, Lavyne MH (1981) Ventriculoatrial shunt for hydrocephalus complicating tuberculous meningitis. Am J Med 70:895–898
Narasimharao KL, Purohit A, Yadav K, Pathak IC (1984) Recurrent abdominal pseudocyst after ventriculoperitoneal shunt. Aust Paediatr J 20(1):73–74
Palur R, Rajshekhar V, Chandy MJ, Joseph T, Abraham J (1991) Shunt surgery for hydrocephalus in tubercular meningitis: a long term follow-up study. J Neurosurg 74:64–69
Raimondi AJ (1998) Hydrocephalus. In: Raimondi AJ (eds) Theoretical principles—art of surgical techniques. (Pediatric Neurosurgery) Springer, Berlin Heidelberg New York, pp 549–619
Rajshekhar V (2009) Management of hydrocephalus in patients with tuberculous meningitis. Neurol India 57:368–374
Sil K, Chatterjee S (2008) Shunting in tuberculous meningitis: a neurosurgeon’s nightmare. Childs Nerv Syst 24:10291032
Tandon V, Mahapatra AK (2011) Management of post-tubercular hydrocephalus. Childs Nerv Syst 27:1699–1707
WHO Global Tuberculosis control 2011, 16th global report on TB. Tuberculosis profile of India
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lyngdoh, B.T., Islam, M.S. Ventriculocholecysto shunt: a solution to recurrent shunt complications in comorbid post-tubercular hydrocephalus with tubercular adhesive peritonitis. Acta Neurochir 154, 2267–2270 (2012). https://doi.org/10.1007/s00701-012-1506-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-012-1506-y