Transanal protrusion of ventriculoperitoneal shunt reflecting asymptomatic perforation of the large bowel

Abstract

Perforation into the gastrointestinal tract is a rare complication of ventriculoperitoneal shunt insertion. We present a case of transanal protrusion of the shunt catheter in an otherwise asymptomatic patient, with only transient signs of shunt failure some 2 months prior to presentation, and discuss treatment options to rationalise our decision to treat with laparotomy and preservation of the shunt.

Anal extrusion of silent migrated ventriculoperitoneal shunt: Case report and literature review

“…However, VP shunt complications remain high [4] . Shunt failure is the most common complication of VP shunts, and 70%-80% of cases need revision and proceed by shunt infection [5] and [6] . Ghritlaharey et al.…”

“…Although bowel perforation is a rare consequence accounting for 0.1%-0.7%, penetration of the catheter tip into the bowel resulting in protrusion of the distal end of the catheter in the external orifice of the anus was well documented in the literature [7] , with a mortality rate as high as 15% [8] . Among other delayed intra-abdominal complications are perforations of the urinary bladder, stomach, fallopian tubes, intestinal obstruction, and pseudocyst formation [ 5 , 9 ]. The reported rate of hollow viscus perforation depends on its mobility.…”

Ventriculo-peritoneal shunt trans-anal protrusion causing Escherichia coli ventriculitis in child: Case report and review of the literature

“…Since that time, 15 cases have been reported [7,8,[12][13][14][15][16][17][18][19][20][21][22][23]. In total, there are 112 cases including our case.…”

If It’s Not Broken, Should We Fix It? Ventriculoperitoneal Shunt Catheter Contributing to Closed-Loop Small Bowel Obstruction in a Pediatric Patient with Ileostomy

“…The remaining VP shunt catheter was repositioned in the peritoneal cavity. The postoperative clinical course was unremarkable with no VP shunt-related complications.Bowel obstruction, necrosis, and perforation are known but rare complications of VP shunt catheters [1][2][3]. Our case highlights a unique neurosurgical dilemma of whether or not to offer surgical intervention for a non-/ malfunctioning VP shunt to a patient who presented with symptoms of partial small bowel obstruction likely worsened by circumferential compression of the small bowel by VP shunt tubing (as shown in imaging).…”