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Spontaneous bowel perforation after ventriculoperitoneal shunt surgery: case report and a review of 45 cases
S Sathyanarayana1, E L Wylen, M K Baskaya
1Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130, USA.
Insights
Ventriculoperitoneal shunts can rarely cause bowel perforation, a serious complication. This case highlights a rectal shunt protrusion and reviews literature on managing this rare event.
Area of Science:
- Neurosurgery
- Gastroenterology
Background:
- Ventriculoperitoneal shunt surgery is a primary treatment for hydrocephalus.
- Delayed abdominal complications, including rare bowel perforations (<0.1%), can occur.
- Bowel perforation is a potentially fatal complication if not promptly diagnosed.
Observation:
- A case report of an adult patient presenting with rectal protrusion of a ventriculoperitoneal shunt tube.
- The patient had a history of shunt surgery and asymptomatic bowel perforation.
- The shunt was successfully removed, and the patient experienced no further complications.
Findings:
- This report analyzes 45 previously documented cases of bowel perforation following shunt surgery.
- The literature review covers symptomatic presentation, diagnostic methods, and microbiological findings.
- Management strategies, including surgical intervention (laparotomy), and patient outcomes are examined.
Implications:
- Highlights the importance of recognizing rare but severe complications of ventriculoperitoneal shunts.
- Informs clinical practice regarding the diagnosis and management of bowel perforation.
- Contributes to the understanding of long-term outcomes for patients with shunt-related bowel complications.
Background:
Ventriculoperitoneal shunt surgery is the most widely used procedure in the treatment of hydrocephalus. However, this invasive procedure has been associated with several delayed abdominal complications. Perforation of the bowel is a very rare complication occurring in less than 0.1% of cases. Although infrequent, this delayed complication can be fatal if it goes unrecognized.
Case Description:
This report presents an adult patient who had undergone ventriculoperitoneal shunt surgery and later presented with rectal protrusion of the shunt tube after asymptomatic perforation of the bowel wall. The shunt was removed without complication and the patient remained asymptomatic.
Conclusions:
Forty-five similar cases have been reported in the literature. The information provided within this report examines the case at hand, as well as provides an analysis of the literature as it relates to bowel perforation through symptomatic presentation, diagnosis, cultures, management with or without laparotomy, and outcome.
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