Systematic literature review of the management of transanal extrusion of distal ventriculoperitoneal shunt catheter: 1966–2020

Ghritlaharey, RajendraK

doi:10.4103/mjdrdypu.mjdrdypu_149_21

Cited by 2 publications

(7 citation statements)

References 77 publications

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“…The probable reason for a greater number of intra-gastric migrations clinically presented as trans-oral extrusion of the distal VPS catheter in children than in adult/older population may be because the number of VPS placements carried out in infants and children are many folds more than done in adults and older age. Like the present findings, a recent review included n = 210 cases of the management of extrusion of the distal part of peritoneal catheter through the anal canal, also evidenced that in 73% of the cases, the age of the cases was ≤ 5 years of age[ 11 ]. For n = 19 of the Group A and n = 9 of the Group B cases, the details of the shunt type/which type of the VPS catheter implanted during the initial procedure was not available/not mentioned by the authors in the manuscripts[ 20 , 21 , 23 - 27 , 29 - 32 , 34 , 36 , 38 , 42 , 43 , 45 , 47 , 48 , 52 , 54 , 55 , 57 - 62 ].…”

Section: Discussionsupporting

confidence: 71%

“…Perforation of the gastrointestinal tract, urinary bladder, and uterus by the distal VPS catheter is a known complication of the VPS placement carried out for the treatment of hydrocephalus, and most of them clinically present with the extrusion of the peritoneal part of a VPS catheter through the natural orifices[ 10 - 14 ]. Perforation of the large bowel by the peritoneal end of a VPS catheter and extrusion of the same via the anal canal is most common and is reported to occur in 0.1% to 2.5% of the cases[ 10 , 11 ]. Migration of the distal VPS catheter into the stomach is a rare clinical entity, and two-thirds of them presented with the trans-oral extrusion of the distal part of peritoneal catheter[ 17 - 62 ].…”

Section: Discussionmentioning

confidence: 99%

“…In n = 5 of Group B cases, the interval from VPS insertion to the detection of the said VPS complication was 3 to 10 years. A recent systematic review (2022) of the n = 210 cases on the management of trans-anal extrusion of the distal VPS catheter also revealed that in 70% of the cases, it occurred within 12 mo after the VPS insertions[ 11 ]. Like the above finding, the present review also revealed that 60% of the entire cases and four-fifths of Group A cases were also diagnosed within 12 mo of the VPS insertion.…”

Section: Discussionmentioning

confidence: 99%

“…The occurrence of peritonitis after the bowel/colon perforation by a distal VPS catheter is not a rule, and it was not reported in most cases. In a systematic review of trans-anal extrusion of the distal VPS catheter, peritonitis was documented only in 3.8% of the cases[ 11 ]. Possibly for similar reasons like colon perforation clinically presented with per-rectal extrusion of VPS catheter, there was no peritonitis even though there was perforation and migration of distal VPS into the stomach in a present review.…”

Section: Discussionmentioning

confidence: 99%

“…Perforation of the hollow viscus viz gastrointestinal tract, urinary bladder, and uterus (female genital tract) by the peritoneal end of a VPS catheter is known, and it may occur with or without extrusion of the distal VPS catheter through the natural orifices[ 10 - 14 ]. Perforation of the large bowel by the peritoneal end of a VPS catheter and protrusion/extrusion of the same via the anal canal is commonly reported[ 10 , 11 ]. Migration of the distal VPS catheter into the stomach is a rare clinical entity[ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Migration of the distal ventriculoperitoneal shunt catheter into the stomach with or without trans-oral extrusion: A systematic literature review and meta-analysis

Ghritlaharey

2023

World J Clin Pediatr

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BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt (VPS) catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter insertion. AIM To identify the demographics, clinical presentation, clinical findings, and results of surgical therapy offered for the treatment of intra-gastric migration of the distal VPS catheter, clinically presented with or without trans-oral extrusion. METHODS An online search was performed for the extraction/retrieval of the published/ available literature pertaining to the above-mentioned VPS complication. Manuscripts were searched from PubMed, PMC (PubMed Central), ResearchGate, and Google Scholar databases using various terminology relating to the VPS complications. The first case of migration of a VPS catheter into the stomach was reported in the year 1980, and the data were retrieved from 1980 to December 2022. Cases were categorized into two groups; Group A: Cases who had migration of the distal VPS catheter into the stomach and clinically presented with trans-oral extrusion of the same, and Group B: Cases who had migration of the distal VPS catheter into the stomach, but presented without trans-oral extrusion. RESULTS A total of n = 46 cases (n = 27; 58.69% male, and n = 19; 41.3% females) were recruited for the systematic review. Group A included n = 32, and Group B n = 14 cases. Congenital hydrocephalus was the indication for the primary VPS insertion for approximately half of the (n = 22) cases. Approximately sixty percent (n = 27) of them were children ≤ 5 years of age at the time of the diagnosis of the complication mentioned above. In seventy-two percent (n = 33) cases, this complication was detected within 24 mo after the VPS insertion/last shunt revision. Clinical diagnosis was evident for the entire group A cases. Various diagnostic modalities were used to confirm the diagnosis for Group B cases. Various surgical procedures were offered for the management of the complication in n = 43 cases of both Groups. In two instances, intra-gastric migration of the distal VPS catheter was detected during the autopsy. This review documented four deaths. CONCLUSION Intra-gastric migration of the peritoneal end of a VPS catheter is one of the rare complications of VPS catheter implantation done for the treatment of hydrocephalus across all age groups. It was more frequently reported in children, although also reported in adults and older people. A very high degree of clinical suspicion is required for the diagnosis of a case of an intra-gastric migration of the distal VPS catheter clinically presenting without trans-oral extrusion.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Migration of the distal ventriculoperitoneal shunt catheter into the stomach with or without trans-oral extrusion: A systematic literature review and meta-analysis

Ghritlaharey

2023

World J Clin Pediatr

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Cerebrospinal fluid shunt catheter extrusion through the mouth in a child: a case report with brief literature review

Ghritlaharey

2024

Int Surg J

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Extrusion of the distal end of the cerebrospinal fluid (CSF) shunt catheter through the mouth is a rare complication of shunt surgery performed to treat hydrocephalus. A two-year-old girl had her first CSF shunt inserted when she was six months old to treat congenital hydrocephalus. The shunt became infected 2-months later and had to be removed. A few weeks later, a new CSF shunt was inserted on the left side. One year later, she presented with an extrusion of the distal end of the CSF shunt catheter through her mouth. However, she showed no symptoms or signs of peritonitis or meningitis. Her entire CSF shunt system on the left side required removal. A cranial magnetic resonance imaging (MRI) scan showed ventriculomegaly and a new CSF shunt catheter was implanted on the right side. She had an uneventful postoperative period and was doing well during the follow-up. Extrusion of the distal end of the CSF shunt catheter through the mouth is rare and more likely to occur in children, and clinicians need to be aware of such complications.

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Systematic literature review of the management of transanal extrusion of distal ventriculoperitoneal shunt catheter: 1966–2020

Cited by 2 publications

References 77 publications

Migration of the distal ventriculoperitoneal shunt catheter into the stomach with or without trans-oral extrusion: A systematic literature review and meta-analysis

Migration of the distal ventriculoperitoneal shunt catheter into the stomach with or without trans-oral extrusion: A systematic literature review and meta-analysis

Cerebrospinal fluid shunt catheter extrusion through the mouth in a child: a case report with brief literature review

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