The risk of abdominal operations in children with ventriculoperitoneal shunts

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  • Additional Information
    • Affiliation:
      Divisions of Neurosurgery, Pediatric Surgery, and Pediatric Urology, Department of Surgery, St Louis University School of Medicine and Cardinal Glennon Children's Hospital, St Louis, MO, USA
    • Note:
      Presented at the 43rd Annual Meeting of the Surgical Section of the American Academy of Pediatrics, New Orleans, Louisiana, October 26–27, 1991.
    • Abstract:
      Ventriculoperitoneal (VP) shunts are the operations of choice for patients with hydrocephalus in most pediatric hospitals. Children with VP shunts frequently undergo abdominal operations unrelated to their shunts, which might lead to shunt infections or to malfunctions related to adhesions. Although prophylactic antibiotics are usually used in this setting, there are few data to support their use, or to assess other risks to the shunt from the abdominal procedures. Consequently, we reviewed the records of 37 children with VP shunts who underwent a total of 44 abdominal operations. In 8 cases, the genitourinary (GU) tract was opened (ureteral reimplantation, bladder augmentation, nephrectomy), whereas in 18 patients the gastrointestinal (GI) tract was opened (appendectomy, gastrostomy, small/large bowel resection). In 18 operations neither GI nor GU tract was opened (lysis of adhesions, herniorrhaphy, orchiopexy). Antibiotic coverage was highly variable: 9 received no antibiotics, 9 received antibiotics only postoperatively, 4 were given antibiotics only preoperatively, and in 22 cases antibiotics were given both preoperatively and postoperatively. One shunt that was involved in a periappendiceal abscess was exteriorized and later successfully replaced. In the remaining cases, no episodes of shunt infection or malfunction occurred in 1 to 10 years of follow-up. Likewise, no abdominal cerebrospinal fluid pseudocysts formed as a result of abdominal adhesions. These data demonstrate that children with VP shunts can safely undergo abdominal operations, even when the GI or GU systems are opened, with minimal risk of shunt infection or malfunction. Rigid protocols of prophylactic antibiotics cannot be supported by this series.
    • ISSN:
      0022-3468
    • Accession Number:
      10.1016/0022-3468(92)90558-O
    • Accession Number:
      002234689290558O
    • Copyright:
      Copyright @ unknown. Published by Elsevier Inc.
  • Citations
    • ABNT:
      PITTMAN, T. et al. The risk of abdominal operations in children with ventriculoperitoneal shunts. Journal of Pediatric Surgery, [s. l.], v. 27, n. 8, p. 1051–1053, 1992. DOI 10.1016/0022-3468(92)90558-O. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edselp&AN=002234689290558O. Acesso em: 12 ago. 2020.
    • AMA:
      Pittman T, Williams D, Weber TR, Steinhardt G, Tracy T. The risk of abdominal operations in children with ventriculoperitoneal shunts. Journal of Pediatric Surgery. 1992;27(8):1051-1053. doi:10.1016/0022-3468(92)90558-O
    • APA:
      Pittman, T., Williams, D., Weber, T. R., Steinhardt, G., & Tracy, T. (1992). The risk of abdominal operations in children with ventriculoperitoneal shunts. Journal of Pediatric Surgery, 27(8), 1051–1053. https://doi.org/10.1016/0022-3468(92)90558-O
    • Chicago/Turabian: Author-Date:
      Pittman, Thomas, Dianne Williams, Thomas R. Weber, George Steinhardt, and Tom Tracy. 1992. “The Risk of Abdominal Operations in Children with Ventriculoperitoneal Shunts.” Journal of Pediatric Surgery 27 (8): 1051–53. doi:10.1016/0022-3468(92)90558-O.
    • Harvard:
      Pittman, T. et al. (1992) ‘The risk of abdominal operations in children with ventriculoperitoneal shunts’, Journal of Pediatric Surgery, 27(8), pp. 1051–1053. doi: 10.1016/0022-3468(92)90558-O.
    • Harvard: Australian:
      Pittman, T, Williams, D, Weber, TR, Steinhardt, G & Tracy, T 1992, ‘The risk of abdominal operations in children with ventriculoperitoneal shunts’, Journal of Pediatric Surgery, vol. 27, no. 8, pp. 1051–1053, viewed 12 August 2020, .
    • MLA:
      Pittman, Thomas, et al. “The Risk of Abdominal Operations in Children with Ventriculoperitoneal Shunts.” Journal of Pediatric Surgery, vol. 27, no. 8, Jan. 1992, pp. 1051–1053. EBSCOhost, doi:10.1016/0022-3468(92)90558-O.
    • Chicago/Turabian: Humanities:
      Pittman, Thomas, Dianne Williams, Thomas R. Weber, George Steinhardt, and Tom Tracy. “The Risk of Abdominal Operations in Children with Ventriculoperitoneal Shunts.” Journal of Pediatric Surgery 27, no. 8 (January 1, 1992): 1051–53. doi:10.1016/0022-3468(92)90558-O.
    • Vancouver/ICMJE:
      Pittman T, Williams D, Weber TR, Steinhardt G, Tracy T. The risk of abdominal operations in children with ventriculoperitoneal shunts. Journal of Pediatric Surgery [Internet]. 1992 Jan 1 [cited 2020 Aug 12];27(8):1051–3. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edselp&AN=002234689290558O