Conservative management of intraventricular migration of a gelatin sponge: illustrative case

J Neurosurg Case Lessons. 2022 May 16;3(20):CASE22126. doi: 10.3171/CASE22126. Print 2022 May 16.

Abstract

Background: Gelatin sponges, such as Gelfoam, are used as hemostatic agents during surgery and are generally absorbed over the course of 4-6 weeks in most body cavities. The time course of the dissolution of Gelfoam sponges within the cerebral ventricles has not been described.

Observations: The authors present a case of intraventricular migration of Gelfoam after ventriculoperitoneal shunt placement in a 6-week-old infant. The infant was imaged regularly after ventriculoperitoneal shunt placement, and the Gelfoam sponge persisted within the ventricles on all images until 11 months after surgery. At no time during follow-up did the patient have any symptoms of hydrocephalus requiring retrieval of the sponge or shunt revision.

Lessons: This is the first case describing time until absorption of a gelatin sponge within the ventricle and successful conservative management.

Keywords: Gelfoam; hydrocephalus; neurosurgery; shunt.