Hepatic and colonic perforation by an abandoned ventriculoperitoneal shunt

Abstract

We report a case of an abandoned distal limb of a ventriculoperitoneal shunt that resulted in hepatic as well as colonic perforation in a 12-year-old girl. Although it is common practice at the time of shunt revision to leave a retained distal catheter in the peritoneal cavity, we suggest this can result in perforation of solid as well as hollow viscera.

Bowel perforation presenting with acute abdominal pain and subcutaneous emphysema in a 14-year-old girl with an abandoned distal peritoneal shunt catheter: case report

“…The etiologies are categorized into 2 mechanisms: 1) acute-traumatic type, in which the initial use of a trocar for distal shunt placement contributes to perforation, and 2) chronic-irritative type, in which shunt migration and adhesion at the entry site lead to perforation of the viscus. 10 In 2 of the cases reviewed, perforation of multiple organs was diagnosed at different chronological points, 5,8 and in our case the small bowel was perforated multiple times. It can be deduced that movements of the distal catheter over time resulted in perforation and that acute trauma from the trocar had no role.…”

Ventriculoperitoneal shunt catheter protrusion through the anus: case report of an uncommon complication and literature review

“…The most frequent (45%) finding in delayed bowel perforation by VP shunt catheters is protrusion of the distal catheter from the anus [1]. In my opinion, this protrusion seems like a chance for the patient as it helps the early diagnosis of perforation as in the case presented herein.…”

Ventriculoperitoneal Shunt Tip as a Rare Cause for Recurrent Pain Episodes in a Child: Think Irritable Peritoneum

“…When cranial imaging studies (computed tomography, magnetic resonance imaging) are without relevant new pathological findings and conventional X-ray may demonstrate unusual positioning of the tip of the VP shunting system, visceral irritation by the shunt itself has to be considered. In more severe cases, this may even result in the perforation of abdominal organs by the catheter [3,5]. To the best of our knowledge, this is the first case report in written form that describes a malpositioned VP shunt as a cause for recurrent painful episodes in a severely neurologically impaired child.…”