title: The incidence of inguinal complications after ventriculoperitoneal shunt for hydrocephalus.
abstract: OBJECTIVE
  This study outlines the incidence of acquired clinical inguinal manifestations (CIM) in infants undergoing ventriculoperitoneal (VP) shunt procedures, and the possible underlying mechanisms in the development of these pathologies.
  
  
  METHODS
  The charts of children who had undergone VP shunt procedures for hydrocephalus between 1992 and 2002 were reviewed. All patients were contacted by a telephone interview, and they were invited to be examined in the outpatient clinic of paediatric surgery for the development of groin manifestation.
  
  
  RESULTS
  Eighty-eight patients responded to the inquiry. Twenty-one (23.8%) patients developed a CIM. Three of them were premature infants. The mean interval between the shunt procedure and the diagnosis of CIM was 5.3 months (20 days to 48 months). Nineteen of the patients who developed a CIM were in the 0- to 12-month age group when the VP shunt procedures were initially performed. Ten CIM occurred on the right (47%), 7 on the left (33%) and 4 were bilateral (20%). The rate of bilateral patency as an operative finding was 76%. There was one recurrence (4.8%).
  
  
  CONCLUSIONS
  The younger the age at which the VP shunt was performed, the higher the incidence of CIM. Bilateral manifestations were higher than in the normal population. Increased intra-abdominal pressure by accumulation of fluid in combination with the high patency rate of processus vaginalis possibly plays a role in the development of CIM in VP shunt patients. Bilateral repair should be considered even when CIM is unilateral. Special care should be given to repair procedures since the recurrence rate is relatively high.
authors.affiliation: Department of Paediatric Surgery, Faculty of Medicine, Ege University, 35100 Bornova, Izmir, Turkey. celika@med.ege.edu.tr
authors.forename: Ahmet
authors.initials: A
authors.lastname: Celik
authors.forename: Orkan
authors.initials: O
authors.lastname: Ergün
authors.forename: M Surhan
authors.initials: MS
authors.lastname: Arda
authors.forename: Taşkin
authors.initials: T
authors.lastname: Yurtseven
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Erşahin
authors.forename: Erol
authors.initials: E
authors.lastname: Balik
mesh_terms: D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*