Extrusion of peritoneal catheter through the mouth

Fermin, Sonia; Fernández-Guerra, Rafael A.; Sureda, Pedro

doi:10.1007/bf00261610

Cited by 19 publications

(14 citation statements)

References 12 publications

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“…7,25,27,32 If a shunt perforates the GI tract, it migrates most often caudally thereafter to protrude through the anal orifice, but has been reported to migrate upward and protrude through the oral cavity. 2,5,6,9,15,21,23,27,29 More than 50% of VP shunt protrusions occur in patients less than 10 years of age. …”

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confidence: 99%

Ventriculoperitoneal shunt perforations of the gastrointestinal tract

Thiong’o

Luzzio

Albright

2015

PED

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OBJECT The purposes of this study were to evaluate the frequency with which children presented with ventriculoperitoneal (VP) shunt perforations of the gastrointestinal (GI) tract, to determine the type of shunts that caused the perforations, and to compare the stiffness of perforating catheters with the stiffness of catheters from other manufacturers. METHODS Medical records were reviewed of 197 children who were admitted with VP shunt malfunction. Catheter stiffness was evaluated by measuring relative resistance to cross-sectional compression, resistance to column buckling, and elasticity in longitudinal bending. Catheter frictional force was measured per unit length. RESULTS Six children were identified whose VP shunts had perforated the GI tract; 2 shunts subsequently protruded through the anal orifice, 1 protruded through the oral cavity, and 3 presented with subcutaneous abscesses that tracked upward from the intestine to the chest. All perforating shunts were Chhabra shunts. Catheter stiffness and resistance to bending were greatest with a Medtronic shunt catheter, intermediate with a Codman catheter, and least with a Chhabra catheter. Frictional force was greatest with a Chhabra catheter and least with a Medtronic catheter. CONCLUSIONS The frequency of perforations by Chhabra shunts appears to be higher than the frequency associated with other shunts. The increased frequency does not correlate with their stiffness but may reflect their greater frictional forces.

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confidence: 99%

Ventriculoperitoneal shunt perforations of the gastrointestinal tract

Thiong’o

Luzzio

Albright

2015

PED

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“…Peroral extrusion of VP shunt is rare. [10][11][12][13] The shunt tube is normally propelled distally by peristalsis after perforation of bowel, but to come out from the mouth, it has to move against normal peristalsis and cross the gastroesophageal junction and esophagus. Once perforated and lying in the stomach or the jejunum, the tube may be made to travel into the oral cavity by forceful repeated vomiting and retching.…”

Section: Discussionmentioning

confidence: 99%

Peroral Extrusion of Ventriculoperitoneal Shunt: An Unusual Complication and Review of Literature

Shah

Singh

Loomba

et al. 2016

IJNS

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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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“…Diagnosis is simple and obvious, as in our case. It is one of the delayed complications related to VP shunt surgery, and it has been found to be associated with young age, male gender, malnutrition, silicon allergy, length of catheter, previous abdominal surgery, and infection .…”

Section: Discussionmentioning

confidence: 99%

“…Management principles include removing the extruding tube, attention to the perforated viscus, and treating associated infection if present. Extruded VPSC have been removed by gentle pulling , laparotomy , and laparoscopic surgery . It is not always easy to pull out an extruded VPSC, as it may adhere to viscus and be surrounded by inflammatory adhesions.…”

Section: Discussionmentioning

confidence: 99%

Laparoendoscopic removal of peroral extrusion of a ventriculoperitoneal shunt

Mandhan

Wong

Samarakkody

2015

Asian J Endoscop Surgery

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Peroral extrusion of a ventriculoperitoneal shunt tube occurs secondary to perforation of the upper GI tract. Managing this condition involves removing the shunt tube, attention to the perforated viscus and associated infection. A combination of endoscopy and laparoscopy provided superior views, enabled identification of the site and size of the perforated viscus, and facilitated the uneventful removal of the tube.

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Extrusion of peritoneal catheter through the mouth

Cited by 19 publications

References 12 publications

Ventriculoperitoneal shunt perforations of the gastrointestinal tract

Ventriculoperitoneal shunt perforations of the gastrointestinal tract

Peroral Extrusion of Ventriculoperitoneal Shunt: An Unusual Complication and Review of Literature

Laparoendoscopic removal of peroral extrusion of a ventriculoperitoneal shunt

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