Faculty Collaboration Database

Pleural effusion in a child with a ventriculoperitoneal shunt and congenital heart disease. Springerplus 2016;5:90

Date

02/06/2016

Pubmed ID

26848430

Pubmed Central ID

PMC4729718

DOI

10.1186/s40064-016-1738-z

Scopus ID

2-s2.0-84961383098 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

We present the unique case of an 8 month old infant who required extracorporeal membrane oxygenation (ECMO) after neonatal repair of tetralogy of Fallot. While on ECMO, he developed grade 3 intraventricular hemorrhage resulting in hydrocephalus requiring ventriculoperitoneal (VP) shunt placement at 5 months of life. He presented to cardiology clinic with a 2-month history of poor weight gain, tachypnea, and grunting and was found to have a large right sided pleural effusion. This was proven to be cerebrospinal fluid (CSF) accumulation secondary to poor peritoneal absorption with subsequent extravasation of CSF into the thoracic cavity via a diaphragmatic defect. After diaphragm repair, worsening ascites from peritoneal malabsorption led to shunt externalization and ultimate conversion to a ventriculoatrial (VA) shunt. This is the second reported case of VA shunt placement in a child with congenital heart disease and highlights the need to consider CSF extravasation as the cause of pleural effusions in children with VP shunts.

Author List

Henningfeld J, Loomba RS, Encalada S, Magner K, Pfister J, Matthews A, Foy A, Mikhailov T

Authors

Andrew Foy MD Adjunct Professor in the Neurosurgery department at Medical College of Wisconsin
Jennifer Henningfeld MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Anne E. Matthews PAC APP Inpatient 1 in the Neurosurgery department at Medical College of Wisconsin
Theresa A. Mikhailov MD, PhD Professor in the Pediatrics department at Medical College of Wisconsin
Jennifer K. Pfister APP Inpatient 2 in the Pediatrics department at Medical College of Wisconsin