Worsening respiratory failure in an adult hydrocephalic patient with a ventriculo-pleural shunt.

2020-11

Wong, Edmond

Jeganathan, Vishnu

Wreghitt, Samuel

Davis, Gavin A

Wimaleswaran, Hari

Howard, Mark E

Cerebrospinal fluid shunts

hydrothorax

pleural effusion

respiratory insufficiency

Journal Article

0000-0002-4335-7582

0000-0003-3727-5000

Ventriculo-pleural (VPL) shunt insertion is performed in hydrocephalic patients when alternative sites of cerebrospinal fluid (CSF) diversion are contraindicated. These include patients with peritoneal complications from ventriculo-peritoneal shunts. Despite its utility, VPL shunts are uncommon. Hydrothoraces should be considered as a potential cause of dyspnoea in the setting of a VPL shunt. We present a case of worsening respiratory failure in the setting of a massive CSF hydrothorax in a hydrocephalic patient with a VPL shunt to highlight this potential complication of pleural CSF diversion, and present a potential management strategy in patients with premorbid underlying lung pathology. In this case, the hydrothorax was drained and the shunt was converted to ventriculo-atrial (VA) shunt.

link

Respirology Case Reports 2020; 8(8): e00660

Respirology Case Reports

2051-3380