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Recurrent perforations of viscus due to ventriculoperitoneal shunt in a hydrocephalic child
T Oshio1, C Matsumura, A Kirino
1Department of Surgery, National Kagawa Children's Hospital, Japan.
Insights
Recurrent gastrointestinal perforation is a rare complication of ventriculoperitoneal shunts for hydrocephalus. Suspect this issue in patients with abdominal symptoms or ventriculitis.
Area of Science:
- Neurosurgery
- Gastroenterology
- Pediatric Surgery
Background:
- Ventriculoperitoneal shunts are commonly used to treat hydrocephalus.
- Gastrointestinal perforation is a rare but serious complication associated with these shunts.
Observation:
- This report details the first documented case of recurrent viscus perforation linked to ventriculoperitoneal shunt placement.
- The patient presented with symptoms suggestive of shunt malfunction and gastrointestinal distress.
Findings:
- The initial gastric perforation was successfully managed using a fibrin sealant.
- A subsequent perforation occurred, requiring laparotomy, where only shunt-related adhesions were noted, highlighting diagnostic challenges.
Implications:
- Clinicians should maintain a high index of suspicion for gastrointestinal perforation in patients with ventriculoperitoneal shunts presenting with abdominal symptoms or ventriculitis.
- Early recognition and appropriate management are crucial for improving patient outcomes in this rare complication.
Abstract:
In this report, we describe the first case of recurrent perforations of viscus due to ventriculoperitoneal shunt for the treatment of hydrocephalus. Based on our own experience and a survey of literature, we suggest that perforation of the gastrointestinal tract should be suspected in patients with ventriculoperitoneal shunt, particularly when abdominal symptoms or ventriculitis are presented. To manage this complication, at the first perforation in the present case, a fibrin sealant was effective for closure of the perforated stomach wall. At the second perforation, when laparotomy was performed, we could not find any abnormality in the abdominal cavity except for a sheath and slight omental adhesions near it.