Transanal presentation of a distal ventriculoperitoneal shunt catheter: Management of bowel perforation without laparotomy

James Bales, Ryan Morton, Nathan Airhart, David Flum, Anthony Avellino

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: Bowel perforation is a serious but rare complication after a ventriculoperitoneal shunt (VPS) procedure. Prior studies have reported spontaneous bowel perforation after VPS placement in adults of up to 0.07%. Transanal catheter protrusion is a potential presentation of VPS bowel perforation and places a patient at risk for both peritonitis and ventriculitis/meningitis via retrograde migration of bacteria. This delayed complication can be fatal if unrecognized, with a 15% risk of mortality secondary to ventriculitis, peritonitis, or sepsis. Case Description: We describe a unique case of a patient with distal VPS catheter protrusion from the anus whose bowel perforation did not cause clinical sequelae of infection. We were able to manage the patient without laparotomy. Conclusions: A subset of patients can be managed without laparotomy and only with externalization of the ventricular shunt with antibiotics until the cerebrospinal fluid cultures finalize without growth.

Original languageEnglish (US)
Pages (from-to)S1150-S1153
JournalSurgical Neurology International
Volume7
Issue number45
DOIs
StatePublished - 2016

Keywords

  • Bowel perforation
  • Complications
  • Ventriculoperitoneal shunt

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Transanal presentation of a distal ventriculoperitoneal shunt catheter: Management of bowel perforation without laparotomy'. Together they form a unique fingerprint.

  • Cite this