Series of 3 Cases of Silent Colonic Perforation by Ventriculoperitonal Shunt Catheter Prolapsing through Anus, an Infrequent Complication: A Case Report

Qassim Al Hinai¹, Neeraj Salhotra^1, , Munthir Al Zabin¹, Azmat Ali¹, Salim Al Abri¹, Mohammad Hashim¹ and S.D Lad¹

¹Department of Neurosurgery, Khoula Hospital, Muscat, Oman, PO box 90, Postal Code 116

Cite this paper

Qassim Al Hinai, Neeraj Salhotra, Munthir Al Zabin, Azmat Ali, Salim Al Abri, Mohammad Hashim and S.D Lad. Series of 3 Cases of Silent Colonic Perforation by Ventriculoperitonal Shunt Catheter Prolapsing through Anus, an Infrequent Complication: A Case Report. American Journal of Medical Case Reports. 2017; 5(3):59-61. doi: 10.12691/AJMCR-5-3-4

Abstract

The ventriculoperitoneal shunt has been the preferred therapy for chronic hydrocephalus for a long time. Complications of this therapy include pseudocyst formation, perforation of the gastrointestinal tract, penetration into solid organs/abdominal wall, protrusion outside the body, disconnection and infection. Bowel perforation is rare complication of VP shunt placement [8]. Silent colonic perforation by ventriculoperitoneal shunt catheter and later patient presenting with catheter prolapsing from anal opening is seen less frequently [1]. We had 3 children 1-3 years old a case of hydrocephalus with ventriculoperitoneal shunt presenting in above scenario. Patients were completely asymptomatic with no features of toxemia indicating a chronic process [2]. Treatment involves pediatric surgical help in removing the shunt catheter, waiting for a sterile cerebrospinal fluid sample via repeated cultures and replacement of shunt catheter in a different quadrant in abdominal cavity.

Keywords

colonic perforation by shunt catheter

Copyright

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References

[1]	Hai A, Rab AZ, Ghani I, Huda MF, Quadir AQ. Perforation into gut by ventriculoperitoneal shunts: A report of two cases and review of the literature. J Indian Assoc Pediatr Surg. 2011 Jan-Mar; 16(1): 31-33.
[2]	Ghritlaharey RK, Budhwani KS, Shrivastava DK, Gupta G, Kushwaha AS, Chanchlani R, Nanda M. Trans-anal protrusion of ventriculo-peritoneal shunt catheter with silent bowel perforation: report of ten cases in children. Pediatr Surg Int. 2007 Jun; 23(6):575-80. Epub 2007 Mar 27.
[3]	Matsuoka H, Takegami T, Maruyama D, Hamasaki T, Kakita K, Mineura K. Transanal prolapse of a ventriculoperitoneal shunt catheter--case report. Neurol Med Chir (Tokyo). 2008; 48(11): 526-8.
[4]	Hayama T, Ishihara S, Yamazaki N, Akahane T, Shimada R, Horiuchi A, Shibuya H, Yamada H, Nozawa K, Matsuda K, Watanabe T. Severance of a ventriculoperitoneal shunt catheter implanted between the cerebral ventricle and peritoneal cavity, resulting in protrusion from the anus. Int Surg. 2011 Apr-Jun; 96(2): 148-52.
[5]	Adeloye A. Protrusion of ventriculo peritoneal shunt through the anus: report of two cases. East Afr Med J. 1997 May; 74(5): 337-9.
[6]	Sathyanarayana S, Wylen EL, Baskaya MK, Nanda A. Spontaneous bowel perforation after ventriculoperitoneal shunt surgery: case report and a review of 45 cases. Surg Neurol. 2000 Nov; 54(5): 388-96.
[7]	Sarkari A, Borkar SA, Mahapatra AK. Anal extrusion of migrated ventriculo-peritoneal shunt catheter: An unusual complication and review of literature. Asian J Neurosurg. 2016 Oct-Dec; 11(4): 459.
[8]	Qassim Al Hinai, Neeraj Salhotra, Munthir Al Zabin,. Azmat Ali. Silent colonic perforation by VP shunt catheter prolapsing through anus: a case report. International Journal of Novel Research in Healthcare and Nursing Vol. 4, Issue 1, pp: (149-153), Month: January - April 2017.