J Korean Med Sci.  2010 Apr;25(4):647-650. 10.3346/jkms.2010.25.4.647.

Acute Shunt Malfunction after Cesarean Section Delivery: A Case Report

• Hwang SC
• Kim TH
• Kim BT
• Im SB
• Shin WH

• KMID: 1792942
• DOI: http://doi.org/10.3346/jkms.2010.25.4.647

Abstract

Shunt malfunctions that require surgical intervention during pregnancy and the postpartum period are rare. Furthermore, no study has reported on an acute shunt malfunction immediately after cesarean section. Here, we describe the case of a 32-yr-old woman who became drowsy 12 hr after cesarean section delivery of her second child. She had a ventriculoperitoneal shunt placed to treat hydrocephalus associated with meningitis at 26 yr of age. Marked ventriculomegaly was seen on brain computed tomography and her consciousness recovered temporarily after aspirating cerebrospinal fluid from the flushing device. At surgery, the distal catheter tip was plugged by a blood clot. We believe that the blood spilled over during the cesarean section. The clogged catheter end was simply cut off and the remaining catheter was repositioned in the peritoneal cavity. Her consciousness recovered fully.

Keyword

Ventriculoperitoneal Shunt; Prosthesis Failure; Hydrocephalus; Cesarean Section

MeSH Terms

Adult
*Cesarean Section
*Equipment Failure
Female
Humans
Hydrocephalus/etiology/surgery
Meningitis/complications
Pregnancy
*Ventriculoperitoneal Shunt/adverse effects/instrumentation

Figure

• 

  Fig. 1 Preoperative CT and X-ray. Ventriculomegaly with a bifrontal index of 41% and effacement of the cortical sulci is seen. The temporal horn of the lateral ventricles is enlarged markedly (A, B). The shunt catheter is well placed in the right lateral ventricle. The abdominal catheter is located in the upper quadrant of the abdomen (C) and the urinary system is filled with contrast material.

• 

  Fig. 2 CT and X-ray on postoperative day 1. The ventriculomegaly and dilation of the temporal horn have returned to normal (A, B). The catheter in the abdomen is shorter than preoperatively (C).

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