Complications of subduroperitoneal shunting

Objects: Subduroperitoneal (SP) shunts have been widely used in the managem ent of pediatric subdural fluid collections. Methods: We retrospectively re viewed the complications of SP shunting in 73 boys and 24 girls, who ranged in age from 1 to 180 months (median 7 months). Subdural fluid collection w as bilateral in 75 and unilateral in 22 patients. The most common complicat ion was shunt obstruction (13 patients). Shunt migration was seen in 8 pati ents. Migration occurred only with unishunts without a reservoir and with p eritoneal catheters. However, the shunts with a reservoir or flushing valve led to skin necrosis in 4 patients (P=0.003). Unilateral drainage though b ilateral collections were present, infection, bowel perforation, and ileus occurred in 5, 4, 1 and 1 patients respectively. Conclusions: These SP shun t complications, some of which are avoidable, should be kept in mind.