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Journal of Case Reports
Appendicitis Causing Ascending Infection Through Ventriculoperitoneal Shunt
Tetsuro Kawazoe1, Masahiko Sugiyama1, Kimiaki Hashiguchi2, Ryota Nakanishi1, Junji Kurashige1, Yuichiro Nakashima1, Hiroshi Saeki1, Eiji Oki1, Yoshihiko Maehara1
Departments of 1Surgery and Science & 2Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Corresponding Author:
Dr. Eiji Oki
Email: okieiji@surg2.med.kyushu-u.ac.jp
Received: 5-OCT-2017 Accepted: 07-AUG-2018 Published Online: 15-SEP-2018
DOI: http://dx.doi.org/10.17659/01.2018.0058
Background: Ventriculo-peritoneal shunts (VPS) are devices that treat neurologic disorders such as hydrocephalus. In patients with VPS, it is occasionally difficult to diagnose appendicitis and to determine the best treatment plan. Case Report: A 17-year-old male with a VPS implanted during childhood complained of right lower quadrant abdominal pain. Laboratory data was consistent with systemic inflammation and computed tomography (CT) findings demonstrated appendicitis with catarrahalis. Based on the low severity of infection and the patient’s desire not to undergo surgery, he was conservatively treated with antibiotics. Unfortunately, he developed three subsequent episodes of acute appendicitis. During the third episode, in the absence of appendix perforation, ascending infection through the VPS caused meningitis. He thus underwent VPS removal and appendectomy. Conclusion: Appendicitis in a patient with VPS should be treated surgically as soon as possible, even in patients with a mild, non-perforated infection. 
Keywords : Appendectomy, Appendicitis, Hydrocephalus, Meningitis, Ventriculoperi-toneal Shunt.
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