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Julieanne P Sees
Nemours/Alfred I. DuPont Hospital for Children, USA
Posters & Accepted Abstracts: Pediatr Ther
The aim of this report is to describe the CT findings encountered when catheter patency is questionable. The role of CT in directing treatment is also evaluated. Records of all children with intrathecal Baclofen (ITB) pump management were reviewed. Only patients with CT evaluation and who had revision pump/catheter surgery were included. From 295 patients with ITB pumps, 16 patients met the inclusion criteria. Four patients had normal CT (the free contrast formed a perfect crescent shape) and had surgery because the pump battery was close to expiration. Five patients had inadequate fluid pooling (the fluid was seen without a crescent shape). Five patients had a fluid leak (the fluid was seen around the pump or in the lumbar canal below the catheter entrance level or outside the canal in the lumbar region). Two patients had catheter occlusion (there was fluid loculation around the catheter tip with no free flow). Based on the experience reported in this study, CT contrast study is a safe and effective method for locating defects in ITB delivery system. When catheter patency is questionable, CT contrast study plays an important role in directing the next step of the management plan.