Staged operations for posthemorrhagic hydrocephalus in extremely low-birth-weight infants with preceding stoma creation after bowel perforation: surgical strategy

Case report We report a complicated extremely low-birth-weight (ELBW) infant with posthemorrhagic hydrocephalus after intraventricular hemorrhageand preceding stomacreation after bowel perforation who was treated with staged operations, including shuntingand external ventricular drainage. The first operation was a temporary valveless ventriculoperitoneal (VP) shuntplacement until the time of the stomaclosure. The stomawas successfully closed 3 months after the first operation when the peritoneal tube was drawn out from the chest wall and the VP shuntsystem was temporarily used as an external drainage with a long subcutaneous tunnel. One month after the second operation, final VP shuntplacement was performed after good healing of bowel anastomosis was surely confirmed. The previous peritoneal shunttube was cut behind the ear, removed, and replaced with a valve-regulated VP shuntsystem.