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 tunnelled 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 hydrocephalus, idiopathic intracranial hypertension, postoperative pseudomeningoceles, and cerebrospinal fluid fistulas 1,2.
Recognized complications include 3,4:
- infection (e.g. meningitis)
- shunt malfunction
- blockage or obstruction
- 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
- 1. Percutaneous Lumboperitoneal Shunt: Review of 130 Cases. (1980) Neurosurgery. 6 (3): 255. doi:10.1227/00006123-198003000-00005 - Pubmed
- 2. Lumboperitoneal shunt for the treatment of hydrocephalus in premature infants. (1987) Acta Neurochirurgica. 84 (3-4): 103. doi:10.1007/BF01418833 - Pubmed
- 3. Duthel R, Nuti C, Motuo-Fotso MJ, Beauchesne P, Brunon J. [Complications of lumboperitoneal shunts. A retrospective study of a series of 195 patients (214 procedures)]. (1996) Neuro-Chirurgie. 42 (2): 83-9; discussion 89-90. Pubmed
- 4. Aoki N. Lumboperitoneal shunt: clinical applications, complications, and comparison with ventriculoperitoneal shunt. (1990) Neurosurgery. 26 (6): 998-1003; discussion 1003-4. Pubmed
- 5. Eric K. Rinker, Todd R. Williams, Daniel T. Myers. CSF shunt complications: what the abdominal imager needs to know. (2015) Abdominal Imaging. 40 (6): 2030. doi:10.1007/s00261-015-0366-3 - Pubmed
- 6. Richard P. Menger, David E. Connor, Jai Deep Thakur, Ashish Sonig, Elainea Smith, Bharat Guthikonda, Anil Nanda. A comparison of lumboperitoneal and ventriculoperitoneal shunting for idiopathic intracranial hypertension: an analysis of economic impact and complications using the Nationwide Inpatient Sample. (2014) Neurosurgical Focus. 37 (5): E4. doi:10.3171/2014.8.FOCUS14436 - Pubmed