Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지

Anal Extrusion of Distal V-P Shunt Catheter after Double Perforation of Large Intestine

  • Jang, Hyun-Dong (Department of Neurosurgery, College of Medicine Yeungnam University) ;
  • Kim, Min-Su (Department of Neurosurgery, College of Medicine Yeungnam University) ;
  • Lee, Nam-Hyuk (Department of Pediatric Surgery, College of Medicine Yeungnam University) ;
  • Kim, Seong-Ho (Department of Neurosurgery, College of Medicine Yeungnam University)
  • Published : 2007.09.28
Download PDF
⟨ Previous Next ⟩

Abstract

We describe the extrusion of a ventriculoperitoneal shunt catheter from the anus after double perforation of the large bowel in a 3-year-old girl with hydrocephalus. She was admitted because the tip of the peritoneal catheter protruded 10 cm from the anus and clear cerebrospinal fluid dripped from the tip. Emergency laparotomy was performed. The distal peritoneal catheter perforated and penetrated the sigmoid colon and re-perforated into the rectal cavity. The distal peritoneal catheter was removed, the proximal catheter was exposed for external drainage, and intravenous broad-spectrum antibiotics were administered for 2 weeks. After control of infection, the shunt system was completely removed. Bowel perforation by a peritoneal catheter is a rare complication. Diagnosis is often difficult, delayed, and its incidence is likely underestimated. Most bowel perforation is the result of infection as opposed to technical errors.

Keywords

References

  1. Adeloye A : Spontaneous extrusion of abdominal tube through the umbilicus complicating peritoneal shunt for hydrocephalus. Case Report. J Neurosurg 38 : 758-760, 1973 https://doi.org/10.3171/jns.1973.38.6.0758
  2. Akcora B, Serarslan Y, Sangun O : Bowel perforation and transanal protrusion of a ventriculoperitoneal shunt catheter. Pediatr Neurosurg 42 : 129-131, 2006 https://doi.org/10.1159/000090470
  3. Boch AL, Hermelin E, Sainte-Rose C, Sgouros S : Mechanical dysfunction of ventriculoperitoneal shunts caused calcification of silicone rubber catheter. J Neurosurg 88 : 975-982, 1998 https://doi.org/10.3171/jns.1998.88.6.0975
  4. Brownlee JD, Brodkey JS, Schaefer IK : Colonic perforation by ventriculaoperitoneal shunt tubing : A case of suspected silicone allergy. Surg Neurol 49 : 21-24, 1998 https://doi.org/10.1016/S0090-3019(97)00014-1
  5. Cuka GM, Helbusch LC : Fracture of peritoneal catheter of cerebrospinal fluid shunts. Pediatr Neurosurg 22 : 101-103, 1995 https://doi.org/10.1159/000120884
  6. De Aquino HB, Carelli EF, Borges Neto AG, Pereira CU : Nonfunctional abdominal complications of thedistal catheter on the treatment of the treatment of hydrocephalus : an inflammatory hypothesis? 'Experience with six cases'. Childs Nerv Syst 22 : 1225-1230, 2006 https://doi.org/10.1007/s00381-005-0025-z
  7. Digray NC, Thappa DR, Arora M, Mengi Y, Goswamy HL : Silent bowel perforation and transanal prolapse of a ventriculoperitoneal shunt. Pediatr Surg Int 16 : 94-95, 2000 https://doi.org/10.1007/s003830050026
  8. Di Rocco C, Marchese E, Vellardi F : A survey of the first complication of newly implanted CSF devices for the treatment of nontumoral hydrocephalus. Childs Nerv Syst 10 : 321-327, 1994 https://doi.org/10.1007/BF00335171
  9. Elisevich K, Mattar AG, Cheeseman F : Biodegeneration of distal shunt catheter. Pediatr Neurosurg 21: 71-76, 1994 https://doi.org/10.1159/000120818
  10. Griffith JA, De Feo D : Peroral extrusion of a ventriculoperitoneal shunt catheter. Neurosurgery 21: 259-261, 1987 https://doi.org/10.1227/00006123-198708000-00028
  11. Heo SH, Gill SB, Lee SY : Fracture of distal catheter after ventriculoperitoneal shunt. J Korean Neurosurg Soc 29 : 693-695, 2000
  12. Johnson MC, Maxwell MS : Delayed intrapleural migration of a ventriculoperitoneal shunt. Child's Nerv Syst 11 : 348-350, 1995 https://doi.org/10.1007/BF00301669
  13. Kim BJ, Cha SH, Park DJ, Song GS, Choi CH, Lee YW : A case of intracardicac migration of distal ventriculo-peritoneal(V-P) shunt catheter. J Korean Neurosurg Soc 29 : 270-273, 2000
  14. Lee BH, Kang SD, Kim JM : CSF ascites complicating ventriculoperitoneal shunting. J Korean Neurosurg Soc 30 : 1345-1347, 2001
  15. Oi S, Shose Y, Oshio T, Matsumoto S : Intragastric migration of a ventriculoperitoneal shunt catheter. Neurosurgery 21 : 255-257, 1987 https://doi.org/10.1227/00006123-198708000-00026
  16. Oshio T, Kirino A, Go M, Bando Y, Manabe Y, Nakagawa Y : Recurrent perforation of viscus due to ventriculoperitoneal shunt in a hydrocephalic child. J Pediatr Surg 26 : 1404-1405, 1991 https://doi.org/10.1016/0022-3468(91)91047-3
  17. Patel CD, Maltloub H : Vaginal perforation as a complication of ventriculoperitoneal shunt. A report of seven cases and review of the literature. Surg Neurol 3 : 265-269, 1973
  18. Thipphavong S, Kellenberger CJ, Rutka JT, Manson DE : Hepatic and colonic perforation by an abandoned ventriculoperitoneal shunt. Pediatr Radiol 34 : 750-752, 2004
  19. Wakai S : Extrusion of peritoneal catheter through the abdominal wall in an infant. Case report. J Neurosurg 57 : 148-149, 1966
  20. Wilson CB, Bertrand V : Perforation of bowel complicating peritoneal shunt for hydrocephalus. Report of two cases. Am Surg 32 : 601-603, 1966
  21. Yousfi MM, Jackson NS, Abbas M, Zimmerman RS, Fleischer DE : Bowel perforation complicating ventriculoperitoneal shunt : Case report and review. Gastrointest Endosc 58 : 144-148, 2003 https://doi.org/10.1067/mge.2003.324