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Suggest Treatment For Abdominal Bloating, Constipation And Swollen Lymph Nodes

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Posted on Mon, 20 Mar 2017
Question: Hello - I have a VP shunt as a result of a massive subarachnoid hemmorage from 1998. I believe the shunt is either malfunctioning or blocked but have been unsuccessful in finding anyone in my area able to look at it. I am almost 900 miles away from Johns XXXXXXX Hospital and am hoping to get up there asap. I was able to get a least a chest x-ray taken and was told nothing was wrong, however I disagree with that. Can you please look at these xrays and tell me if you see granulomas or adhesions along the shunt tract, and does the shunt tubing look twisted or possibly disconnected? I believe the shunt is overdraining or blocked altogether. Having problems with my vision, my gait, balance, pressure in head, some mild cognitive difficulties, and pain under right rib cage, abdominal swelling and bloating as well as constipation and mild urinary incontinence. This is a VP Shunt.
Are those swollen lymph nodes or lymphomas I see there or granulomas or adhesions to the tubing? It looks like the tubing has become twisted. Thank you!
doctor
Answered by Dr. Indu Kumar (2 hours later)
Brief Answer:
Shunt appears to be in right position.

Detailed Answer:
Hello,
Thanks for writing to HealthcareMagic,
I've gone through your query and understand your concern,

I have gone through all the images.
Shunt appears to be in right position.It doesn't seem to be twisted.
It is not possible to comment on blockade from chest X-ray.
You may need clinical examination and further investigations.
There are no signs of enlarged lymph nodes,lymphoma etc.
But cardiac size is enlarged (cardiomegaly).

Your symptoms may need proper neurological examination and MRI of brain.
You may also need ultrasound of abdomen due to bloating,constipation.

I suggest to consult a neurologist.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Indu Kumar (5 hours later)
Are you seeing what looks like granulomas or adhesions around the shunt? I am getting pain under my right rib cage. What are the small white hyperintensities I'm seeing there, please?

The tubing should run straight up and down, not bent as shown in 2nd image.

Here now where I am if you are over 60 years old they don't want to spend much money on you for anything, so you're pretty much left to do any treatments on your own if you want to live, which is why I am asking you. They like to save money, you know.

I saw the cardiomegaly - what can be done for that at this point?
doctor
Answered by Dr. Indu Kumar (44 minutes later)
Brief Answer:
There are no granuloma,fibrosis near the shunt.

Detailed Answer:
Hello,
Thanks for writing to HealthcareMagic,
I've gone through your query and understand your concern,

There are no granuloma,fibrosis near the shunt.
White dot like lesions are end on blood vessels.These are normal.

Course of shunt is normal.

Cardiomegaly need cardiac evaluation.ECHO may be advised after clinical evaluation.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Indu Kumar (1 hour later)
I do not see any of these white dots on prior chest xray.

Why is this?

Also under arm in 2nd xray (side view).

Are these not lymph nodes?


Thank you, Dr. XXXXXXX I appreciate the response!

On the 2nd x-ray - see the shunt tubing bending downward?

This tubing is to be straight upward - it is not supposed to be bent - it is kinked - it is bent - are you seeing this?
doctor
Answered by Dr. Indu Kumar (2 hours later)
Brief Answer:
Few dots are always present and these are end view of blood vessels.

Detailed Answer:
Hello,
Thanks for writing back,
I've gone through your query and understand your concern,

Few dots are always present and these are end view of blood vessels.
There are no enlarged lymph nodes. Lymph nodes are lobulated in shape and it is not present in your X-ray.

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX

Brief Answer:
It is normally bend in abdomen and it is straight in thorax(which is normal

Detailed Answer:
Hello,
Thanks for writing back,
I've gone through your query and understand your concern,

It is normally bend in abdomen and it is straight in thorax(which is normal).

Get well soon.

Hope I have answered your query.
Further queries are most welcome.

Take Care
Dr. Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6729 Questions

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Suggest Treatment For Abdominal Bloating, Constipation And Swollen Lymph Nodes

Brief Answer: Shunt appears to be in right position. Detailed Answer: Hello, Thanks for writing to HealthcareMagic, I've gone through your query and understand your concern, I have gone through all the images. Shunt appears to be in right position.It doesn't seem to be twisted. It is not possible to comment on blockade from chest X-ray. You may need clinical examination and further investigations. There are no signs of enlarged lymph nodes,lymphoma etc. But cardiac size is enlarged (cardiomegaly). Your symptoms may need proper neurological examination and MRI of brain. You may also need ultrasound of abdomen due to bloating,constipation. I suggest to consult a neurologist. Get well soon. Hope I have answered your query. Further queries are most welcome. Take Care Dr. Indu XXXXXXX