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Journal of Korean Neurosurgical Society 2007;42(3): 232-234.
Anal Extrusion of Distal V-P Shunt Catheter after Double Perforation of Large Intestine.
Hyun Dong Jang, Min Su Kim, Nam Hyuk Lee, Seong Ho Kim
1Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea. shkim@med.yu.ac.kr
2Department of Pediatric Surgery, College of Medicine, Yeungnam University, Daegu, Korea.
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.
Key Words: Hydrocephalus; Ventriculoperitoneal shunt; Intestinal perforation
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