Numerous complications can occur after the placement of a venticuloperitoneal shunt. The late onset of an autoimmune disease such as Crohn's disease can be the disruptive factor for a previously well functioning shunt. A 33-year-old female with a ventriculo-peritoneal shunt since the age of 7, as well as Crohn's disease since the age of 25, presented in the ER with dysuria, long-lasting fever and intermittent severe headache. The patient underwent a CT scan of the chest, abdomen and brain. An enlargement of the ventricular system was revealed, suggesting malfunction of the shunt. Simultaneously, the abdominal scan revealed an abnormal course of the peritoneal catheter of the shunt in the lower abdomen, inside the bladder. The existence of the catheter inside the bladder was confirmed and filmed during a cystoscopy and was attributed to the several inflammations and surgeries performed for the treatment of Crohn's disease.The absence of an obvious stenosis of the aqueduct, the early immunodeficiency due to Azathioprine and the multiple abdominal surgeries made the treatment selection a complex algorithm for the neurosurgeon.
Gkolemis, C; Zogopoulos, P; Kokkalis, P; Stamatopoulos, G; Syrmos, N; and Paleologos, T.S.
"Management of multiple, late onset complications in a 33-year-old female, with a ventriculoperitoneal shunt and crohn's disease,"
Pakistan Journal of Neurological Sciences (PJNS): Vol. 9
, Article 10.
Available at: http://ecommons.aku.edu/pjns/vol9/iss3/10