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Post-shunt ascites in infants with optic chiasmal hypothalamic astrocytoma: role of ventricular gallbladder shunt

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Abstract

Introduction

We report a series of infants with optic chiasmal hypothalamic astrocytomas (OCHAs) who developed abdominal ascites following ventriculo-peritoneal (VP) shunting. The mechanism of ascites development among these patients with OCHA remains speculative and unclear.

Methods

We treated four infants with hypothalamic tumors who were shunted for hydrocephalus using standard VP shunts and who subsequently experienced symptomatic ascites.

Results

In three patients the gallbladder proved an effective alternative site for shunting prior to conversion to other sites, and in one patient the gallbladder shunt remains functional and revision-free.

Conclusions

Several aspects of the gallbladder as a reservoir for CSF make this approach appealing. Ventricular gallbladder shunting provided an effective (at least temporarily) receptacle for CSF in these patients.

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References

  1. Adegbite AB, Khan M (1982) Role of protein content in CSF ascites following ventriculoperitoneal shunting. J Neurosurg 57:423–425

    Google Scholar 

  2. Barami K, Sood S, Ham S, Canady A (1998) Chemical meningitis from bile reflux in a lumbar-gallbladder shunt. Pediatr Neurosurg 29:328–330

    Article  CAS  PubMed  Google Scholar 

  3. Bernstein RA, Hsueh W (1985) Ventriculocholecystic shunt: a mortality report. Surg Neurol 23:31–37

    Article  CAS  PubMed  Google Scholar 

  4. Gil Z, Beni-Adani L, Siomin V, Nagar H, Dvir R, Constantini S (2001) Ascites following ventriculoperitoneal shunting in children with chiasmatic-hypothalamic gliomas. Childs Nerv Syst 17:395–398

    Article  CAS  PubMed  Google Scholar 

  5. Ketoff J, Klein R, Maukkassa K (1997) Ventricular cholecystic shunts in children. J Pediatr Surg 32:181–183

    Article  CAS  PubMed  Google Scholar 

  6. Keucher TR, Mealey J (1979) Long term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus. J Neurosurg 50:179–186

    Google Scholar 

  7. Novelli PM, Reigel DH (1997) A closer look at the ventriculo-gallbladder shunt for the treatment of hydrocephalus. Pediatr Surg 26:197–199

    CAS  Google Scholar 

  8. Shuper A, Horev G, Michovitz S, Korenreich L, Zaizov R, Cohen IJ (1997) Optic chiasm glioma, electrolyte abnormalities, nonobstructive hydrocephalus and ascites. Med Pediatr Oncol 29:33–35

    Article  CAS  PubMed  Google Scholar 

  9. Smith GW, Moretz WH, Pritchard WL (1958) Ventriculo-biliary shunt, a new treatment for hydrocephalus. Surg Forum 9:701–705

    CAS  PubMed  Google Scholar 

  10. Stringel G, Turner M, Crase T (1993) Ventriculo-gallbladder shunts in children. Childs Nerv Syst 9:330–333

    Google Scholar 

  11. Vernet O, Campiche R, de Tribolet N (1995) Long-term results after ventriculo-atrial shunting in children. Childs Nerv Syst 11:176–179

    CAS  PubMed  Google Scholar 

  12. West K, Turner MK, Vane DW, Boaz J, Kalsbeck J, Grosfeld JL (1987) Ventricular gallbladder shunts: an alternative procedure in hydrocephalus. J Pediatr Surg 22:609–612

    CAS  PubMed  Google Scholar 

  13. West GA, Berger MS, Geyer JR (1994) Childhood optic pathway tumors associated with ascites following ventriculoperitoneal shunt placement. Pediatr Neurosurg 21:254–259

    CAS  PubMed  Google Scholar 

  14. Yasuda T, Tomita T, McLone DG, Donovan M (2002) Cerebrospinal fluid (CSF) output measurement through external ventricular drainage in one hundred infants and children: correlation with CSF production. Pediatr Neurosurg 36:22–28

    Article  PubMed  Google Scholar 

  15. Yount RA, Glazier MC, Mealey J, Kalsbeck JE (1984) Cerebrospinal fluid ascites complicating ventriculoperitoneal shunting. J Neurosurg 61:180–183

    Google Scholar 

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Correspondence to Tadanori Tomita.

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Olavarria, G., Reitman, A.J., Goldman, S. et al. Post-shunt ascites in infants with optic chiasmal hypothalamic astrocytoma: role of ventricular gallbladder shunt. Childs Nerv Syst 21, 382–384 (2005). https://doi.org/10.1007/s00381-004-0996-1

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  • DOI: https://doi.org/10.1007/s00381-004-0996-1

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