Post-shunt ascites in infants with optic chiasmal hypothalamic astrocytoma: role of ventricular gallbladder shunt

Childs Nerv Syst. 2005 May;21(5):382-4. doi: 10.1007/s00381-004-0996-1. Epub 2004 Sep 22.

Abstract

Introduction: We report a series of infants with optic chiasmal hypothalamic astrocytomas (OCHAs) who developed abdominal ascites following ventriculo-peritoneal (VP) shunting. The mechanism of ascites development among these patients with OCHA remains speculative and unclear.

Methods: We treated four infants with hypothalamic tumors who were shunted for hydrocephalus using standard VP shunts and who subsequently experienced symptomatic ascites.

Results: In three patients the gallbladder proved an effective alternative site for shunting prior to conversion to other sites, and in one patient the gallbladder shunt remains functional and revision-free.

Conclusions: Several aspects of the gallbladder as a reservoir for CSF make this approach appealing. Ventricular gallbladder shunting provided an effective (at least temporarily) receptacle for CSF in these patients.

Publication types

  • Comparative Study

MeSH terms

  • Ascites*
  • Astrocytoma / complications
  • Astrocytoma / pathology
  • Astrocytoma / surgery*
  • Cerebrospinal Fluid Shunts
  • Female
  • Gallbladder / surgery
  • Humans
  • Hydrocephalus / complications
  • Hydrocephalus / pathology
  • Hydrocephalus / surgery*
  • Hypothalamic Neoplasms / complications
  • Hypothalamic Neoplasms / pathology
  • Hypothalamic Neoplasms / surgery*
  • Infant
  • Male
  • Optic Chiasm / pathology
  • Optic Chiasm / surgery*
  • Ventriculoperitoneal Shunt / methods*