COVID 19 ve Pediatrik Hastalarda Şant Disfonksiyonu: Pandemiden Edinilen Tecrübe

Öz

Amaç: Ventriküloperitoneal (VP) şant cerrahisi, hidrosefali tedavisinde en yaygın kabul gören yöntemdir. Şant disfonksiyonu, farklı etiyolojilere sahip yaygın bir komplikasyondur. Bu çalışma, pandemi döneminde şant disfonksiyonu nedeniyle cerrahi uygulanan ve ameliyat öncesi dönemde COVID-19 pozitif olan pediatrik hastaları değerlendirmeyi amaçlamaktadır. Materyal-metod: Mart 2020 ile 2023 tarihleri arasında şant disfonksiyonu ön tanısıyla cerrahi tedavi uygulanan hastaların bulguları retrospektif kesitsel bir tasarım ile incelendi. Hastaların yaşı, cinsiyeti, COVID-19 pozitiflik tarihi, başvuru semptomları, BOS bulguları, BOS kültürü, kan testleri ve uygulanan tedaviler hasta dosyaları ve elektronik kayıtlar üzerinden elde edildi. Bulgular: Ameliyat öncesi dönemde COVID-19 pozitif olan ve VP şant disfonksiyonu gelişen 13 pediatrik hastanın verileri değerlendirildi. Ateş (%61,5) ve emmede azalma/huzursuzluk (%62,5) en sık görülen semptomlardı. İki hastada pozitif BOS kültürü tespit edildi. Biyokimyasal anormallikler arasında D-dimer ve transaminaz yüksekliği gözlendi. Sonuç: COVID-19, solunum semptomları olmasa bile gastrointestinal ve peritoneal tutulum yoluyla şant disfonksiyonuna katkıda bulunabilir. COVID-19 ve hidrosefali tanısı olan çocuk hastalarda, klinisyenler şant disfonksiyonu olasılığına karşı yüksek şüphe düzeyini korumalıdır.

Anahtar Kelimeler

• Hidrosefali
• Pediatrik Nöroşirürji
• Şant Revizyonu
• SARS-CoV-2

COVID-19 and Shunt Dysfunction in Pediatric Patients: Experience From the Pandemic

Öz

Aim: Ventriculoperitoneal (VP) shunt surgery is the most widely accepted method for the treatment of hydrocephalus. Shunt dysfunction is a common complication with various etiologies. This study aimed to evaluate pediatric patients who underwent surgery due to shunt dysfunction during the pandemic period and were COVID-19 positive in the preoperative period. Material and Methods: The findings of the patients who underwent surgical treatment with a preliminary diagnosis of shunt dysfunction between March 2020 and 2023 were examined in the present study. A retrospective cross-sectional design was adopted. Age, sex, date of COVID-19 positivity, symptoms at presentation, CSF findings, CSF culture, blood tests, and applied treatments of the patients were obtained from patient files and electronic records. Results: Among 13 pediatric patients with VP shunt dysfunction and preoperative COVID-19 positivity, fever (61.5%) and decreased sucking/restlessness (62.5%) were the most frequent symptoms. Two patients had positive CSF cultures. Biochemical abnormalities were observed, including elevated D-dimer and transaminases. Conclusion: COVID-19 may contribute to shunt dysfunction through gastrointestinal and peritoneal involvement, even in the absence of respiratory symptoms. Clinicians should maintain high suspicion for shunt malfunction in pediatric patients with COVID-19 and hydrocephalus.

Anahtar Kelimeler

• Hydrocephalus
• Pediatric Neurosurgery
• Shunt Revision
• SARS-CoV-2

Kaynakça

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