Abdominal pain
 

I live in a remote community in Northern Ontario Canada. We have no neurosurgeon here, not even a neurologist, so I'm often at a loss at what to do with any shunt problems. I had a vp shunt placed in 1996 at the age of 41 and although my condition improved initially, it has deteriorated since. I did have several CT scans and MRIs since and they all indicate the pressure on the brain is building, the brain is shrinking, but no neurosurgeon wants to operate. They all say it's too dangerous. Now, I'm experiencing pain for the first time at the adominal end of the shunt. Sometimes, it's stabbing, other times just a dull ache. It interferes with sleep and is driving me nuts. Doctors up here don't even know what hydrocephalus is and the neurologist that used to come here, only does teleconferences now...something I'm unable to follow. What I want to know is whether this abdominal pain is something to worry about. I've always had headaches, seizures etc. and doctors seem to think that's normal, but abdominal pain right at the shunt exit?? I have no explanation for that. And in the absence of doctors who know up here, I'm wondering what to do.

Hi jeff, im sorry to hear youre in such pain :(

the night after i have a distal end revision surgery, i had abdominal pain, sounding just like you described, stabbing pain and dull ache.
ive had this every day now for about 130 days atleast.

i have had so many test done, nothing came back with anything suspicious, apart froom fluid building up in my abdomen, ive had several abdominal aspirations, all coming back clear form infection, actually im waiting for the results of one now, as i had one 2 days ago.

My neuro surgeon thinks that the pain is caused by the build up of the fluid i have that was detected on ultrasound.

It was also possible that its adhesional pain, or irritation caused by the distal end.

Pseudocysts can also caused abdominal pain...
i suggest you request an abdominal aspiration and also a shunt tap to test for infection. If this is ruled out as no infection then i guess thats one thing of the list.

due to the pain im having, im having the shunt converted to a VA shunt, which will involve moving the tube to the heart instead, im having this done next week or the week after. Hopefully this will resolve the pain.
maybe this could be another suggestion you could ask your NS.

good luck xo:)

I finally gave in today and went back to hospital where after four hours of investigations, the emergency room doctor now believes the distal end of the shunt may be blocked with debris. He says unlike the top end of the shunt, the bottom end flows freely in the abdomen and can become obstructed. So he's ordered ultrasound of the abdomen to investigate. He says sometimes the problem can be resolved with surgery, sometimes without and sometimes the debris, if present, clears on its own. At any rate, I know have a place to start. Unfortunately, the ultrasound up here can't be done until Feb. 10, but at least now I have some answers. Jeff

As a further update, I had ultrasound on abdomen today. Although, normally left for a doctor, the X-ray tech gave me the results. She said she could see no obstruction at the distal end of the shunt. She surprised me in that the distal end of my shunt is way over by my right hip. I thought it was in the centre of the stomach. At any rate, she said an MRI or CT of the stomach may be necessary to determine if there is any blockage. She said because of my weight (almost 300lbs.) it's hard to follow the shunt with ultrasound. Jeff