title: Ventriculoperitoneal shunt complications needing shunt revision in children: a review of 5 years of experience with 48 revisions.
abstract: BACKGROUND
  The aim of this study was to review the management of ventriculoperitoneal (VP) shunt complications in children.
  
  
  METHODS
  During the last 5 years (January 1, 2006 to December 31, 2010), 236 VP shunt operations were performed in children under 12 years of age; of these, 40 (16.94%) developed shunt complications and those who underwent VP shunt revisions were studied.
  
  
  RESULTS
  This prospective study included 40 (28 boys and 12 girls) children and required 48 shunt revisions. Complications following VP shunts that required shunt revisions were peritoneal catheter/peritoneal end malfunction (18), shunt/shunt tract infections (7), extrusion of peritoneal catheter through anus (5), ventricular catheter malfunction (4), cerebrospinal fluid (CSF) leak from abdominal wound (4), shunt system failure (2), ventricular end/shunt displacement (2), CSF pseudocysts peritoneal cavity (2), extrusion of peritoneal catheter from neck, chest, abdominal scar and through umbilicus, one each. Four-fifth of these shunt complications occurred within 6 months of previous surgery. Surgical procedures done during shunt revisions in order of frequency were revision of peritoneal part of shunt (27, 56.25%), revision of entire shunt system (6, 12.5%), extra ventricular drainage and delayed re-shunt (5, 10.41%), shunt removal and delayed re-shunt (5, 10.41%), opposite side shunting (2, 4.16%), cysts excision and revision of peritoneal catheter (2, 4.16%) and revision of ventricular catheter (1, 2.08%). The mortalities following VP shunt operations were 44 (18.64%) and following shunt revisions were 4 (10%).
  
  
  CONCLUSIONS
  VP shunt done for hydrocephalus in children is not only prone for complications and need for revision surgery but also associated with considerable mortality.
authors.affiliation: Department of Paediatric Surgery, Gandhi Medical College and Associated, Kamla Nehru and Hamidia Hospitals Bhopal, Madhya Pradesh, India. drrajendrak1@rediffmail.com
authors.forename: Rajendra K
authors.initials: RK
authors.lastname: Ghritlaharey
authors.forename: Keshav S
authors.initials: KS
authors.lastname: Budhwani
authors.forename: Dhirendra K
authors.initials: DK
authors.lastname: Shrivastava
authors.forename: Jyoti
authors.initials: J
authors.lastname: Srivastava
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies; D012086:Reoperation; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*