In 1985, I was 3 years old and my shunt became obstructed:
10/9/85
Postoperative Diagnosis: Obstructed and distracted ventricular peritoneal shunt.
Operation: Right Ventricular peritoneal Shunt, Removal of Old VP shunt with abdominal alparotomy for removal of abdominal catheter.
Note:
Patient is almost 4 years old and underwent VP shunting at birth. She has done well until just recently when she had some headaches and recently had a CT scan which revealed essentially normal size ventricles and intracranial pressure of approximately 200. She was sent home to be watched by her mother and then returned on this date, approximately two weeks later complaining about pain in her head, abdominal pain with nausea, vomiting and lethargy. Richham reservoir was tapped and no fluid could be obtained.
A shunt series revealed the abdominal catheter was completely contained within the abdominal cavity, Patient, therefore underwent a repeat CT scan which revealed dilated ventricular wire cath and patient was taken to surgery for replacement after removal of the old VP shunt.
OPERATION:
Patient was brought to the OR Suite anesthetizes, intubated and placed on the OR table. The old curvilinear incision in the head as extended. A brand new burr hole was placed. A flange barium ventricular catheter was placed in to the right frontal horn with a return of clear fluid.
The old Rickham reservoir and ventricular catheter were removed from the old site and the new ventricular catheter connected to the new Richkam reservoir which was connected in turn to a medium pressure Holter valve (mannometrics tested prior to placement).
A new abdominal incision just below the old one was lateral on the right side of the abdomen. A brand new spring distal low pressure abdominal cathether was brought up to the abdominal wound up to the head by the means of two stab wound incisions and a subcutaneous tunneler device. The peritoneal and posterior sheath were closed with a #4-0 interrupted Nurolon suture except in a small segment in which a purse-string suture was placed around the catheter which was in the abdominal cavity.
The wounds were irrigated with saline and Bacitracian solution and then closed in layers from inside out utilizing #3-0 interrupted Nurgulon sutures. The skin was closed with #4-0 running Ethilon sutures. Standard dressings were placed on the wound.
The child was taken to the Recovery Room in Satisfactory condition.
I was discharged and sent home.
I had to return to the hospital six weeks later....