Relationship Between Ventriculoperitoneal Shunt Obstruction and Infection in Pediatric Patients with Hydrocephalus

Abstract

Objective: The most common ventriculoperitoneal shunt (VPS) complications in pediatric patients include shunt infections and obstructions. This study evaluated the relationship between shunt infection and obstruction in pediatric patients undergoing VPS placement for hydrocephalus at our clinic. Materials and Methods: Altogether, 210 patients ≤16 years old who were diagnosed with hydrocephalus and who received VPS placement by the same surgeon between January 2012 and June 2017 were followed up for at least one year and were evaluated retrospectively. Patients' clinical and laboratory findings were evaluated, and computed tomography and magnetic resonance imaging were performed. Pearson's chi-squared and Fisher–Freeman–Halton tests were used for statistical data analysis. Results: Among the 210 patients, shunt complications developed in 86; of these 86 patients, shunt infections, shunt obstructions, and other complications developed in 41, 53 (non-infection-related: 31 and infection-related: 22), and 14 patients, respectively. The infection rate in patients in whom VPS placement was performed from the frontal region was lower than those patients in whom it was performed from the occipitoparietal region. The obstruction rate was significantly higher in patients with shunt infection than in those without. Obstruction occurred in one-third of the patients with Staphylococcus epidermidis infection among patients with shunt infection. Conclusion: The obstruction rate in patients with shunt infection was three times higher than those without. Considering that shunt infection may accompany obstruction, making the decisions regarding the treatment method for patients with shunt obstruction is appropriate, after determining whether a shunt infection exists.

Keywords

• hydrocephalus
• infection
• ventriculoperitoneal shunt