Open AccessWorsening respiratory failure in an adult hydrocephalic patient with a ventriculo‐pleural shunt
Author(s) -
Wong Edmond,
Jeganathan Vishnu,
Wreghitt Samuel,
Davis Gavin,
Wimaleswaran Hari,
Howard Mark E
Publication year - 2020
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.660
Subject(s) - medicine , shunt (medical) , hydrothorax , surgery , complication , respiratory failure , hydrocephalus , cerebrospinal fluid , anesthesia , ascites
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.