Unusual ventriculoperitoneal (vp) shunt tube extrusion through anus in a child: Case report and review of literature

Abstract

Background: The diversion of cerebrospinal fluid (CSF) for hydrocephalus is an established surgical practice.Ventriculo-peritoneal shunting is the most commonly performed diversion procedure. However, the procedure is associated with wide variety of complications, neurological, and non-neurological, which can occur in immediate perioperative period or during follow-up. Anal extrusion of a peritoneal catheter is a rare complication ranging from 0.1 to 0.7% of all shunt surgeries. Case description: We present a rare case of anal extrusion of ventriculoperitoneal shunt in A 1 year and 7 months old male child who presented with extruding distal peritoneal tip of shunt tube per anus of 48 h duration and five episode of vomiting of ingested matter. The physical examination did not reveal any signs of peritonitis or meningitis. There was palpable VP shunt valve which was functional and Peritoneal end of the catheter was protruding through the anus.After proper investigation and family councelling,child was taken to the Operation theater and proximal catheter exteriorized and distal end removed via the anus.After three weeks of IV antibiotics,VPS revised and patient discharged. Conclusion: Though trans-anal VPS extrusion is rare complication,awareness of this unusual complication among general Neurosurgeons and physicians is very important for early recognition, management, and timely intervention to save the life of the patient.

Keywords

• Hydrocephalus
• Transanal extrusion
• Ventriculo-peritoneal shunt
• Shunt revision
• Migration