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Vol. 28. Issue 4.
Pages 202-206 (July - August 2017)
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Vol. 28. Issue 4.
Pages 202-206 (July - August 2017)
Caso clínico
Hidrotórax como complicación de la derivación ventriculoperitoneal: caso clínico
Hydrothorax as a complication of a ventricle peritoneal shunt. A case report
Raúl M. Yébolesa,
Corresponding author
rmyeboles@hotmail.com

Autor para correspondencia.
, Lorena Vázqueza, Marta Seoanea, Susana Castroa, Beatriz Ruizb
a Servicio de Pediatría, Complejo Hospitalario Universitario de A Coruña, A Coruña, España
b Servicio de Pediatría, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, España
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Statistics
Figures (1)
Tables (2)
Tabla 1. Casos de hidrotórax de líquido cefalorraquídeo sin migración torácica del catéter peritoneal
Tabla 2. Parámetros de laboratorio en sangre, líquido pleural (LP) y líquido cefalorraquídeo (LCR)
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Resumen

La derivación ventriculoperitoneal (DVP) es el tratamiento habitual en caso de hidrocefalia. Se trata de una técnica sencilla y eficaz, pero hasta un 70% de los pacientes presentan algún tipo de complicación a lo largo de su vida. La mayoría de ellas son debidas a infección o disfunción mecánica, siendo las complicaciones torácicas poco frecuentes. El presente caso es uno de los pocos encontrados en la literatura en el que se objetiva hidrotórax como complicación de la DVP sin migración de la punta de catéter y sin ascitis.

Describimos el caso de una niña de 2años con DVP. La paciente es diagnosticada de derrame pleural compatible con hidrotórax. Tras análisis de β2-transferrina en líquido pleural se comprobó que se trataba de líquido cefalorraquídeo. El TAC craneal mostró un catéter de DVP normoposicionado. La radiografía y la ecografía de abdomen mostraron punta de catéter bien situada en peritoneo.

Palabras clave:
Derrame pleural
Derivación ventriculoperitoneal
Hidrocefalia
Hidrotórax
Transferrina
Abstract

The ventricle peritoneal (VP) shunt is commonly used in the treatment of hydrocephalus. It is a relatively simple and effective technique, but around 70% of the patients with a VP shunt have a complication in their lifetime. Most of these complications are due to infection or mechanical dysfunction. The thoracic complications are rare. The present case is one of the small number of them found in the literature, describing hydrothorax as a complication of a VP shunt without catheter migration and without ascites.

The case is presented of a 2 year-old girl with VP shunt. The patient was diagnosed with pleural effusion compatible with hydrothorax. After finding beta-2-transferrin in the pleural fluid, it was it was shown to be from cerebrospinal fluid. Cranial CT showed the catheter in a proper position, and the Xray and ultrasound showed the catheter correctly positioned in the peritoneum.

Keywords:
Pleural effusion
Ventricle peritoneal shunt
Hydrocephalus
Hydrothorax
Transferrin

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