Name of the Procedure:

Shuntogram for investigation of previously placed indwelling nonvascular shunt (e.g., LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation.

Summary

A shuntogram is a radiological procedure used to examine the function and integrity of an existing nonvascular shunt, such as a LeVeen shunt, ventriculoperitoneal (VP) shunt, or an indwelling infusion pump. It involves injecting a contrast dye through the shunt and using imaging techniques to visualize its flow and detect any abnormalities.

Purpose

This procedure is performed to diagnose problems in an existing shunt designed to redirect bodily fluids, such as cerebrospinal fluid or ascites, to another part of the body for absorption. The goal is to ensure the shunt is functioning correctly, identify blockages, leaks, or malfunctions, and plan appropriate treatments.

Indications

• Suspected shunt malfunction
• Symptoms of increased intracranial pressure (for VP shunts)
• Abdominal pain or swelling (for LeVeen shunts)
• Signs of infection or shunt disconnection
• Unexplained symptoms that may be related to shunt performance
• Periodic evaluation in patients with known shunt systems

Preparation

• Follow fasting instructions if sedation or anesthesia is used.
• Adjust medications as directed by a healthcare provider.
• Undergo any required blood tests or imaging studies before the procedure.

Procedure Description

1. The patient is positioned appropriately.
2. Local anesthesia is administered to numb the shunt area, and sedation may be provided if necessary.
3. A contrast dye is injected through a catheter into the shunt system.
4. Radiographic images are taken to track the dye's movement and visualize the shunt pathway.
5. The radiologist interprets the images to assess shunt function and detect any abnormalities.

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

The procedure is usually performed in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist
• Radiologic technologist
• Nurse
• Anesthesiologist (if sedation is used)

Risks and Complications

• Infection at the injection site
• Allergic reaction to the contrast dye
• Bleeding or hematoma formation
• Discomfort or pain during the procedure
• Potential for shunt damage, though rare

Benefits

• Accurate diagnosis of shunt function and issues
• Informs appropriate interventions to correct shunt problems
• Minimally invasive with a clear visual assessment of the shunt system

Recovery

• Patients can usually go home the same day.
• Monitor the injection site for signs of infection.
• Follow any specific instructions given by the healthcare provider.
• Resume normal activities as advised, with potential restrictions based on shunt location and patient condition.

Alternatives

• Clinical observation and symptom monitoring
• Other imaging methods like MRI or CT scan without contrast
• Surgical exploration (more invasive)

Patient Experience

During the procedure, the patient may feel a slight sting from the injection and mild pressure as the contrast dye is introduced. There may be temporary discomfort, but pain management measures will be provided. After the procedure, patients might experience minor soreness at the injection site.

Pain management and comfort measures are available to ensure patient comfort, including local anesthesia and, if needed, sedation.