Tuesday, April 17, 2018

Re: Constipation can cause shunt failure

Thank you so much for this reply and considering our concerns. We are going to see Dr Borchert now so we will decide whether to go forward today or tomorrow. 

On Tue, Apr 17, 2018 at 9:11 AM McComb, Gordon <GMcComb@chla.usc.edu> wrote:

Dear Ms. Abercrombie,

 

You are correct that severe constipation can lead to raised intra-abdominal pressure that can result in reduced CSF drainage that in turn leads to symptoms of raised intracranial pressure and in some cases ventricular dilation.

 

In your note you stated that Ian's abdomen was not distended, hard nor sensitive to pressure.  This would indicate that the intra-abdominal pressure is not high and thus unlikely the cause of the malfunction.

 

Also the ventricles have dilated significantly which is generally not the case in this situation.

 

Just reviewed the shunt series.   The shunt is malfunctioning as the distal end is out of the abdominal cavity.

 

The shunt definitely needs to be revised.

 

 

J. Gordon McComb, MD

Chief Emeritus
Division of Neurosurgery
Children's Hospital Los Angeles
Professor

Department of Neurological Surgery
USC Keck School of Medicine
1300 N. Vermont Avenue, Suite 1006
Los Angeles, CA  90027
P: 323.361.2169
F: 323.361.3101
gmccomb@chla.usc.edu

 

             

 

From: Shari Abercrombie [mailto:me@shariabercrombie.com]
Sent: Tuesday, April 17, 2018 5:44 AM
To: Cynamon, Harry A.; Borchert, Mark; McComb, Gordon
Subject: Constipation can cause shunt failure (EXTERNAL EMAIL)

 

I know you all prob donor prefer to correspond via email but given the timing of this situation I needed to share this. 

 

I have no idea why Ian is still constipated but this was really interesting find. 

 

Research ——

 

 

 

NOTE——

Constipation: Severe constipation can increase intra-abdominal pressure and thereby alter the CSF intracranial-peritoneal pressure differential, eventually leading to shunt malfunction.5

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