Disseminated intravascular coagulation associated with ventriculoperitoneal shunt surgery: Case report

James L. Frazier, G. Steven Bova, Kathryn Jockovic, Elizabeth A. Hunt, Benjamin Lee, Edward S. Ahn

Research output: Contribution to journalArticlepeer-review

Abstract

Disseminated intravascular coagulation (DIC) as a complication of surgery for ventriculoperitoneal (VP) shunts is extremely rare, and only one case has been documented in the literature. The authors present the case of a 9-year-old girl with shunted hydrocephalus who presented with a 3-day history of headaches and vomiting. A head CT showed enlarged ventricles compared with baseline. An emergent VP shunt revision was performed, during which an obstructed proximal catheter was found. Immediately after extubation, the patient became apneic and progressed to cardiopulmonary arrest. A breathing tube was reinserted followed by resuscitation attempts that led to extracorporeal membrane oxygenation. Soon after reintubation, bloody drainage was noted in the endotracheal tube, and subsequent laboratory studies were consistent with DIC. The patient died on postoperative Day 1, and autopsy findings confirmed DIC. Note that DIC is a recognized complication of trauma, particularly with brain injury, but it is rare with neurosurgical procedures. Disseminated intravascular coagulation should be considered if excessive bleeding occurs after any brain insult.

Original languageEnglish (US)
Pages (from-to)306-309
Number of pages4
JournalJournal of Neurosurgery: Pediatrics
Volume5
Issue number3
DOIs
StatePublished - Mar 2010

Keywords

  • Brain
  • Disseminated intravascular coagulation
  • Shunt

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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