Dynamic plain abdominal film provides simple and effective diagnosis of delayed shunt insufficiency caused by abdominal adhesions after VP shunt
Abstract Background Many complications may occur after placement of the ventriculoperitoneal shunt (VP shunt) for hydrocephalus, and delayed shunt insufficiency (DSI) is among the most common. It is often caused by abdominal adhesions, which increases the difficulty of diagnosis. This study aimed to...
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| Language: | English |
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BMC
2024-09-01
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| Series: | Chinese Neurosurgical Journal |
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| Online Access: | https://doi.org/10.1186/s41016-024-00378-z |
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| author | Zhiqiang Liu Jintao Chen Chaoqun Weng Bei Liu Zhixiong Lin |
| author_facet | Zhiqiang Liu Jintao Chen Chaoqun Weng Bei Liu Zhixiong Lin |
| author_sort | Zhiqiang Liu |
| collection | DOAJ |
| description | Abstract Background Many complications may occur after placement of the ventriculoperitoneal shunt (VP shunt) for hydrocephalus, and delayed shunt insufficiency (DSI) is among the most common. It is often caused by abdominal adhesions, which increases the difficulty of diagnosis. This study aimed to explore the clinical value of dynamic plain abdominal radiography (DPAR) as a simple diagnostic method for patients with DSI due to terminal adhesion of the peritoneal shunt after VP surgery. Methods A total of 30 patients with high suspicion of DSI due to abdominal adhesions after VP surgery were included. DPAR was used for prospective assessment. The interval between the first and second PAR was 4–6 h before surgery. If two plain abdominal radiography at different times indicated that the end of the shunt tube in the abdominal segment was fixed, it was diagnosed as DSI due to adhesion of the shunt tube at the abdominal end. The peritoneal end of the shunt tube was surgically repositioned. Postoperative DPAR was repeated to evaluate the distance of the shunt outlet within the abdominal segment. Results All cases showed clinical symptoms or imaging findings of shunt insufficiency. The diagnostic accuracy of DPAR was 96.67% (29/30). The end of the shunt tube in the abdominal segment of the preoperative group was fixed with abdominal plain film twice with a mean difference of 1.74 ± 1.18 cm. The mean postoperative change in the position of the end of the shunt tube in the abdominal section was 9.36 ± 2.64 cm, showing a significant difference compared with the preoperative group (P < 0.001). The mean postoperative EVANs index (0.37 ± 0.08) was significantly lower than the preoperative (0.42 ± 0.08) (P = 0.007), Glasgow coma scale score (12.8 ± 2.69) was higher than the mean preoperative score (11.36 ± 2.43) (P = 0.013). Conclusion DPAR is a simple and effective method for the diagnosis of shunt insufficiency caused by delayed abdominal end adhesion after VP shunt. |
| format | Article |
| id | doaj-art-a020a4766eed42cebd7d5ce52165aa30 |
| institution | Kabale University |
| issn | 2057-4967 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Chinese Neurosurgical Journal |
| spelling | doaj-art-a020a4766eed42cebd7d5ce52165aa302025-01-05T12:09:02ZengBMCChinese Neurosurgical Journal2057-49672024-09-0110111010.1186/s41016-024-00378-zDynamic plain abdominal film provides simple and effective diagnosis of delayed shunt insufficiency caused by abdominal adhesions after VP shuntZhiqiang Liu0Jintao Chen1Chaoqun Weng2Bei Liu3Zhixiong Lin4Department of Neurosurgery, Fujian Sanbo Funeng Brain HospitalDepartment of Neurosurgery, Fujian Sanbo Funeng Brain HospitalDepartment of Neurosurgery, Fujian Sanbo Funeng Brain HospitalDepartment of Neurosurgery, Fujian Sanbo Funeng Brain HospitalDepartment of Neurosurgery, Fujian Sanbo Funeng Brain HospitalAbstract Background Many complications may occur after placement of the ventriculoperitoneal shunt (VP shunt) for hydrocephalus, and delayed shunt insufficiency (DSI) is among the most common. It is often caused by abdominal adhesions, which increases the difficulty of diagnosis. This study aimed to explore the clinical value of dynamic plain abdominal radiography (DPAR) as a simple diagnostic method for patients with DSI due to terminal adhesion of the peritoneal shunt after VP surgery. Methods A total of 30 patients with high suspicion of DSI due to abdominal adhesions after VP surgery were included. DPAR was used for prospective assessment. The interval between the first and second PAR was 4–6 h before surgery. If two plain abdominal radiography at different times indicated that the end of the shunt tube in the abdominal segment was fixed, it was diagnosed as DSI due to adhesion of the shunt tube at the abdominal end. The peritoneal end of the shunt tube was surgically repositioned. Postoperative DPAR was repeated to evaluate the distance of the shunt outlet within the abdominal segment. Results All cases showed clinical symptoms or imaging findings of shunt insufficiency. The diagnostic accuracy of DPAR was 96.67% (29/30). The end of the shunt tube in the abdominal segment of the preoperative group was fixed with abdominal plain film twice with a mean difference of 1.74 ± 1.18 cm. The mean postoperative change in the position of the end of the shunt tube in the abdominal section was 9.36 ± 2.64 cm, showing a significant difference compared with the preoperative group (P < 0.001). The mean postoperative EVANs index (0.37 ± 0.08) was significantly lower than the preoperative (0.42 ± 0.08) (P = 0.007), Glasgow coma scale score (12.8 ± 2.69) was higher than the mean preoperative score (11.36 ± 2.43) (P = 0.013). Conclusion DPAR is a simple and effective method for the diagnosis of shunt insufficiency caused by delayed abdominal end adhesion after VP shunt.https://doi.org/10.1186/s41016-024-00378-zHydrocephalusVP shuntDelayedShunt insufficiency |
| spellingShingle | Zhiqiang Liu Jintao Chen Chaoqun Weng Bei Liu Zhixiong Lin Dynamic plain abdominal film provides simple and effective diagnosis of delayed shunt insufficiency caused by abdominal adhesions after VP shunt Chinese Neurosurgical Journal Hydrocephalus VP shunt Delayed Shunt insufficiency |
| title | Dynamic plain abdominal film provides simple and effective diagnosis of delayed shunt insufficiency caused by abdominal adhesions after VP shunt |
| title_full | Dynamic plain abdominal film provides simple and effective diagnosis of delayed shunt insufficiency caused by abdominal adhesions after VP shunt |
| title_fullStr | Dynamic plain abdominal film provides simple and effective diagnosis of delayed shunt insufficiency caused by abdominal adhesions after VP shunt |
| title_full_unstemmed | Dynamic plain abdominal film provides simple and effective diagnosis of delayed shunt insufficiency caused by abdominal adhesions after VP shunt |
| title_short | Dynamic plain abdominal film provides simple and effective diagnosis of delayed shunt insufficiency caused by abdominal adhesions after VP shunt |
| title_sort | dynamic plain abdominal film provides simple and effective diagnosis of delayed shunt insufficiency caused by abdominal adhesions after vp shunt |
| topic | Hydrocephalus VP shunt Delayed Shunt insufficiency |
| url | https://doi.org/10.1186/s41016-024-00378-z |
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