Images in clinical medicine | Volume 38, Article 202, 23 Feb 2021 | 10.11604/pamj.2021.38.202.28032

Ventriculoperitoneal shunt fracture in a child

Prastiya Indra Gunawan, Uuk Riuh Kusuma Wardana

Corresponding author: Prastiya Indra Gunawan, Department of Child Health, Universitas Airlangga, College of Medicine, Dr Soetomo General Academic Hospital, Surabaya, Indonesia

Received: 24 Jan 2021 - Accepted: 10 Feb 2021 - Published: 23 Feb 2021

Domain: Neurology (general),Pediatric neurology

Keywords: Fracture, child, ventriculoperitoneal shunt

©Prastiya Indra Gunawan et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Prastiya Indra Gunawan et al. Ventriculoperitoneal shunt fracture in a child. Pan African Medical Journal. 2021;38:202. [doi: 10.11604/pamj.2021.38.202.28032]

Available online at: https://www.panafrican-med-journal.com/content/article/38/202/full

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Images in clinical medicine

Ventriculoperitoneal shunt fracture in a child

Ventriculoperitoneal shunt fracture in a child

Prastiya Indra Gunawan1,&, Uuk Riuh Kusuma Wardana1

 

1Department of Child Health, Universitas Airlangga, College of Medicine, Dr Soetomo General Academic Hospital, Surabaya, Indonesia

 

 

&Corresponding author
Prastiya Indra Gunawan, Department of Child Health, Universitas Airlangga, College of Medicine, Dr Soetomo General Academic Hospital, Surabaya, Indonesia

 

 

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Ventriculoperitoneal shunt (VPS) fracture is one of malfunction shunt. In pediatric cases, catheter fractures are observed most frequently in the growing period of the patient along with increasing height. Most fractures are reported on the connection side or the side with intense fibrosis because of the repeated pressure. Fracture shunt can be caused by immune reaction, calcification and abrasion leading to shunt dysfunction. A 5-years-old boy presented with headache, vomiting, non-specific abdominal discomfort, high fever, seizure and decrease of consciousness. He was previously hydrocephalic with large head size since birth. A VPS was already inserted twice in 3 months and 5 years old. Neurological examination showed the patient somnolen and Babinski reflexes were positive. Routine hematological investigation revealed leukocytosis. Cerebrospinal fluid (CSF) culture revealed Staphylococcus aureus and CSF analysis showed bacterial infection. A contrast-enhanced computed tomography (CT) scan showed left ventriculomegaly and pneumoventricular lateral ventricle, agenesis septum pellucidum, left subdural hygroma in regio fronto-parieto-occipito temporalis. From Plain abdominal X-ray showed of fractured VP shunt tip in abdominal cavity. Emergency surgery was performed to evacuate VPS and antibiotic given based on CSF culture result. The patient was hospitalized about one month and improved leaving neurological sequalae.

 

 

Figure 1: plain abdominal X-ray showed of fractured ventriculoperitoneal shunt tip in abdominal cavity

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Images in clinical medicine

Ventriculoperitoneal shunt fracture in a child

Images in clinical medicine

Ventriculoperitoneal shunt fracture in a child

Images in clinical medicine

Ventriculoperitoneal shunt fracture in a child

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Key words

Fracture

Child

Ventriculoperitoneal shunt

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