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Radiating shoulder tip pain after VP shunt placement has been reported as an unusual complication in a few cases, associated with dislocation of the peritoneal catheter. We described the case of a 9-year-old girl who presented with recurrent radiating shoulder tip pain after VP shunt placement. The pain recurred after peritoneal catheter repositioning because of peritoneal inflammation and adhesion due to peritonitis with Propionibacterium acnes (P. acnes). This bacterium was isolated using 16S ribosomal RNA gene polymerase chain reaction (16S rRNA gene PCR), and anaerobic and prolonged culture tests. After antibacterial treatment, ventriculoarterial (VA) shunt placement was successfully performed. Hemidiaphragm irritation by the peritoneal catheter leads to radiating shoulder tip pain, and peritoneal inflammation and adhesion caused by infectious peritonitis may cause recurrence of this despite catheter repositioning. Clinicians should be aware of shoulder pain as a complication of VP shunt placement, and should consider VA shunt placement as an alternative treatment if this symptom recurs after catheter repositioning. 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Propionibacterium acnes関連腹膜炎によりVPシャント後に繰り返し肩への放散痛を呈した一例
https://uoeh-u.repo.nii.ac.jp/records/872
https://uoeh-u.repo.nii.ac.jp/records/872d8662f0d-1bcf-478b-b765-62ae0cc0e9c5
名前 / ファイル | ライセンス | アクション |
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S00042207 (1.6 MB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2020-06-30 | |||||
タイトル | ||||||
タイトル | Propionibacterium acnes関連腹膜炎によりVPシャント後に繰り返し肩への放散痛を呈した一例 | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | Recurrent Shoulder Tip Pain After Ventriculoperitoneal Shunt Placement Associated with Infectious Peritonitis with Propionibacterium acnes; A Case Report and Review of the Literature | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 肩放散痛 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | VPシャント | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | VAシャント | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Propionibacterium acnes | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 小児脳神経外科 | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | shoulder pain | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | ventriculoperitoneal shunt | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | ventriculoarterial shunt | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | propionibacterium acnes | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | pediatric neurosurgery | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
鈴木, 恒平
× 鈴木, 恒平× 齋藤, 健× 酒井, 恭平× 宮川, 正× 本田, 裕子× 保科, 隆之× 小川, 将人× 浅井, 完× 山内, 健× 山本, 淳考× Suzuki , Kohei× Saito, Takeshi× Sakai, Kyohei× Miyagawa, Tadashi× Honda, Yuko× Hoshina, Takayuki× Ogawa, Masato× Asai, Hiroshi× Yamanouchi, Takeshi× Yamamoto , Junkoh |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Ventriculoperitoneal (VP) shunt placement is commonly performed for the treatment of hydrocephalus, and several complications of this procedure are well known. Radiating shoulder tip pain after VP shunt placement has been reported as an unusual complication in a few cases, associated with dislocation of the peritoneal catheter. We described the case of a 9-year-old girl who presented with recurrent radiating shoulder tip pain after VP shunt placement. The pain recurred after peritoneal catheter repositioning because of peritoneal inflammation and adhesion due to peritonitis with Propionibacterium acnes (P. acnes). This bacterium was isolated using 16S ribosomal RNA gene polymerase chain reaction (16S rRNA gene PCR), and anaerobic and prolonged culture tests. After antibacterial treatment, ventriculoarterial (VA) shunt placement was successfully performed. Hemidiaphragm irritation by the peritoneal catheter leads to radiating shoulder tip pain, and peritoneal inflammation and adhesion caused by infectious peritonitis may cause recurrence of this despite catheter repositioning. Clinicians should be aware of shoulder pain as a complication of VP shunt placement, and should consider VA shunt placement as an alternative treatment if this symptom recurs after catheter repositioning. Furthermore, 16S rRNA gene PCR and anaerobic and prolonged culture tests should be considered to detect P. acnes infection. | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | 脳室腹腔(VP)シャント術は水頭症に対して一般的に行われ,手術に伴ういくつかの合併症についてもよく知られている.一方,VPシャント後に迷入した腹側カテーテルによる横隔膜の刺激に伴う肩への放散痛は稀な合併症として数例の報告があるのみである.今回,Propionibacterium acnes(P. acnes)関連腹膜炎による腹膜の炎症と癒着のため,VPシャント再建術後にも繰り返し肩への放散痛を呈した9歳女児の症例を経験した.P. acnes は一般培養検査で検出されず,16SリボソームRNA遺伝子ポリメラーゼ連鎖反応(16SrRNA遺伝子PCR)および嫌気性培養,増菌培養で検出され,十分な抗生剤治療の後,脳室心房(VA)シャント術を施行し,その後肩への放散痛は再燃なく経過している.腹側カテーテルによる横隔膜への器械的な刺激は肩への放散痛を引き起こし,カテーテルの入れ替えによって改善するとされるが,感染性腹膜炎による腹膜の炎症や癒着はカテーテルの入れ替え後も症状を再燃させる因子になる可能性がある.稀ながら腹側カテーテルによる肩への放散痛はVPシャントの合併症として認識する必要がある.また,カテーテル交換後も症状再燃を繰り返す際には,弱毒菌による感染症の除外のためPCRや嫌気・増菌培養を行い,VAシャントへの切り替えを検討する必要がある. | |||||
書誌情報 |
産業医科大学雑誌 en : Journl of UOEH 巻 42, 号 2, p. 209-216, 発行日 2020-06-01 |
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出版者 | ||||||
出版者 | 産業医科大学(産業医科大学学会) | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | ISSN 0387-821X(PRINT), ISSN 2187-2864(ONLINE) | |||||
関連サイト | ||||||
識別子タイプ | URI | |||||
関連識別子 | https://www.uoeh-u.ac.jp/kouza/journal/intro_e.html | |||||
関連名称 | Journal of UOEH | |||||
関連サイト | ||||||
識別子タイプ | URI | |||||
関連識別子 | https://www.uoeh-u.ac.jp/kouza/journal/intro_j.html | |||||
関連名称 | 産業医科大学雑誌 | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 |