Ventriculoperitoneal shunt infection has become an important concern in cases of hydrocephalus. Due to the development of a high proportion of antibiotic resistance, we recommend an empirical therapy of antibiotic therapy for prophylaxis and suspected infection in ventriculoperitoneal shunt surgery.
Several case reports regarding complications of ventriculoperitoneal (VP) shunt have been published, but peroral extrusion of shunt tube is unusual and reported less frequently. A 4-year-old male child with previous history of VP shunt insertion for congenital hydrocephalus along with shunt revisions twice presented with peritoneal end of shunt tube protruding through the mouth following an acute episode of vomiting. He was conscious without any signs of infection or neurologic deficits. The distal portion of the tube was removed uneventfully with the help of upper GI endoscope that, in addition to removal, provided better views for the identification of site and size of perforation. Peroral extrusion of the shunt tube needs immediate treatment that includes removal of extruded shunt tube, treatment of underlying infection, and attention to perforated viscus. We review the possible pathogenesis of this entity and various treatment options.
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