A Study of Various Shunt Related Complications in a Tertiary Care Hospital

Objective: The purpose of this study is to evaluate the frequency of various complication in patients with ventri-culoperitoneal shunt (VP shunt) for hydrocephalous in a tertiary care hospital.Material and Methods: This descriptive study on patients for whom Ventriculoperitoneal shunt was done for hydrocephalus was carried out in neurosurgery department, Hayatabad Medical Complex, Peshawar from 1st May 2010 to 30th February 2013. Only patients of hydrocephalous with established complication from both gen-ders without age discrimination were included in the study and patients with complications after revised shunts were excluded as complications rate is different in the two entities and will bias the study results. The patients were seen either in emergency room, ward or neurosurgical OPDs. Routine follow up schedule was examination at discharge, one month and then 6 months post operatively on outpatient bases. History, Clinical examination and full investigations which included FBC,CRP , CSF R/E (if required to rule out infection), X-Ray shunt series and CT scan brain and ultrasound abdomen pelvis were done as required in all patients. The clinical data was put into semi structured Performa and analyzed by SPSS version 10. Frequency and percentage was calculated for categorical variables. Mean ± SD was calculated for age. Results were presented as graphs and tables.Results: The total number of children operated upon was 112 of whom 71 (63.39%) males and 41 (36.61%) females. Forty one patients (36.61%) were less than one year at the time of presentation. Thirty seven (33.03%) patients were in age range of 1 – 10 years, 19 (16.96%) were in 11 – 20, 10 (8.92%) were in 21 – 30 age range, 4 (3.57%) were from 31 – 40 and one patient (0.89%) was in the age range of 41 – 50. Shunt blockage was seen in 54 (48.21%) followed by infection 38 (33.93%). Shunt erosion was seen in 11 (9.82%), extrusion in 5 (4.46%). While 4 patients died in the study period due to shunt related complications.Conclusion: The commonest shunt related complication is shunt blockage followed by shunt infection. Upper end of the shunt is more prone to complications than the lower end .Shunt related complications are serious clinical conditions and may lead to death of the patient