Lumboperitoneal shunt

Last revised by Dr Yusra Sheikh on 07 Feb 2022

Lumboperitoneal (LP) shunts are a device used to shunt cerebrospinal fluid in the treatment of increased CSF pressure.

As the name suggests, a catheter is placed with its tip in the lumbar spinal canal (intrathecal). The distal catheter is tunneled under the skin and into the peritoneal cavity. The catheter may or may not have a valve that regulates the flow of CSF based on a preset pressure. 

It is used for CSF shunting of no intracranial mechanical or local cause of obstruction e.g. communicating hydrocephalusidiopathic intracranial hypertension, postoperative pseudomeningoceles, and cerebrospinal fluid fistulas 1,2.

Complications

Recognized complications include 3,4:

  • infection (e.g. meningitis)
  • puncture site trauma
  • shunt malfunction
    • blockage or obstruction
    • disconnections/breaks
    • shunt kinking 7 
    • migration
    • leakage
    • over drainage
    • under drainage
  • distal complications
    • anterior abdominal wall pseudocyst formation 5
    • rarely, the distal end can encircle the bowel and cause strangulation
  • intraspinal complications
    • chronic subdural effusion
    • acquired Chiari abnormality

See also

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Case 1
    Drag here to reorder.
  • Case 2: for acquired tonsillar ectopia
    Drag here to reorder.
  • Case 3
    Drag here to reorder.
  • Case 4: dislodged LP shunt
    Drag here to reorder.
  • Case 5: complicated with pseudocyst
    Drag here to reorder.
  • Case 6: on abdominal x-ray
    Drag here to reorder.
  • Case 6: Abdominal wall pseudocyst secondary to lumboperitoneal shunt malpositioning
    Drag here to reorder.