Ventriculo-ureteric shunts, the last resort in complicated shunt patients

Abstract

Ventriculo-Ureteric Shunts (V-U Shunts) are the proverbial ‘Hail-Mary’ in the hydrocephalus Neurosurgeon’s arsenal. When all else fails, this innovative procedure can alleviate the suffering of hydrocephalus patients, whose abdomens are unsuitable for shunt placement.This surgery isn’t new, being discovered and modified almost a decade ago. The procedure done by us, utilized a percutaneous X-ray guided nephrostomy, which along with a subcutaneous tunneller allowed for an elegant and minimally invasive procedure.We present a case of recurrent shunt blocks and infections in a patient who developed toxic megacolon and severe peritonitis, thereby making his abdomen unsuitable for shunt placement. The patient was subjected to the V-U shunt. Although some perioperative problems occurred, long term follow up with a multidisciplinary approach lead to success with complete resolution of all symptoms. Along with this remarkable report, we present a review of recent literature, with reported complications and risks.

Keywords

• Ventriculo-Ureteric Shunts
• Ventriculo-Peritoneal Shunts
• Peritonitis
• Abdomen
• Hydrocephalus
• Ureter