Abstract
Ventriculoperitoneal (VP) Shunt is a commonly performed surgical procedure and offers a good result in the treatment of hydrocephalus. In general, 25% of the complication rate of this surgical procedure is abdominal complications. Anal extrusion of a peritoneal catheter is a rare complication ranging from 0.1 to 0.7% of all shunt surgeries. This study presents a rare case of anal extrusion of ventriculoperitoneal shunt in a 1-year-old female child who was asymptomatic. The physical examination revealed swelling and redness along the shunt tract on the retro auricular region, soft abdomen, and no catheter was observed in the anal. This study found several contributing factors affecting the complications in the anal extrusion of a peritoneal catheter, that are thin bowel wall in children and sharp tip and stiff end of VP shunt. The shunt should be disconnected from the abdominal wall, and the lower end should be removed through the rectum by colonoscopy or sigmoidoscopy/proctoscopy or by applying gentle traction on the protruding tube. This study concludes that due to potentially life-threatening consequences and case rarity, thorough anamnesis, physical examination, and objective investigation are needed to determine the appropriate management for anal extrusion of ventriculoperitoneal shunt.Â
Highlights
The placement of Ventriculoperitoneal (VP) Shunt as a diversion of cerebrospinal fluid (CSF) for hydrocephalus has been established as a surgical practice since early
This study presented a case of a 1-year-old female child with anal Extrusion of Ventriculoperitoneal Shunt
This study presented a case of a 1-year-old female child with anal EVS, which is a rare complication, ranging from 0.1 to 0.7% of shunt surgeries [7]
Summary
The placement of Ventriculoperitoneal (VP) Shunt as a diversion of cerebrospinal fluid (CSF) for hydrocephalus has been established as a surgical practice since early. Various complications have been reported, including shunt infection, migration, and cerebrospinal fluid pseudocyst. Cerebrospinal fluid pseudocysts peritoneal cavity is being reported as an unusual complication with a reported incidence of less than 1% to 4.5% of ventriculoperitoneal shunting (VPS)(2). Caudal migration is usually asymptomatic, whereas cranial migration is typically symptomatic [4]. Some abdominal complications are fibrous encasement of the peritoneal tip, blocking or kinking of the distal tube, slipping out through the surgical wound, and migration of the shunt or its components into various abdominal cavities [5] Bowel perforation with protrusion of VP shunt catheter from the anus is reported to occur in less than. This study reported a usual complication of shunt procedure through an anal opening
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