title: [Percutaneous endoscopic gastrostomy in children with ventriculoperitoneal shunt].
abstract: The complications of percutaneous endoscopic gastrostomy (PEG) placement or replacement or of home management of gastrostomy, must be taken in account in patients with hydrocephalus and ventriculoperitoneal shunt. In this report we describe four children with spastic quadriplegia and ventriculoperitoneal shunt who had a median follow-up of 15 months (range 4-32 months) after PEG placement. Intravenous antibiotic prophylaxis was always used during routine procedures and no shunt infection was observed. In a patient, during accidental PEG dislodgement, peritoneal infection developed that required temporary diversion of the catheter. A second dislodgement, in the same individual, determined a large amount of serous peritoneal fluid that needed to be evacuated but no shunt infection or malfunction. In nobody of our patients, the shunt, located in the upper left abdomen, interfered with gastrostomy placement. Our experience confirms that PEG is not contraindicated in patients with ventriculoperitoneal shunt, provided that the risks of catheter infection are known and prevented.
authors.affiliation: Clinica Pediatrica, Università di Verona, Policlinico GB Rossi, Verona. e.valletta@virgilio.it
authors.forename: E
authors.initials: E
authors.lastname: Valletta
authors.forename: G
authors.initials: G
authors.lastname: Angelini
authors.forename: A
authors.initials: A
authors.lastname: Castagnini
authors.forename: E
authors.initials: E
authors.lastname: Fontana
authors.forename: R
authors.initials: R
authors.lastname: Piccoli
authors.forename: D
authors.initials: D
authors.lastname: Ulmi
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D005260:Female; D005773:Gastroscopy; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D017287:Ventriculoperitoneal Shunt