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Peroral extrusion of the peritoneal catheter in an infant

Mahesh Gupta1, Naseeb C Digra, Narendra Sharma

  • 1Department of Surgery, M.M. Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India.

North American Journal of Medical Sciences
|July 4, 2012
PubMed

Insights

A rare complication, ventriculo-peritoneal shunt tube peroral extrusion, occurred when a distal catheter fractured and protruded from a child's mouth. This case highlights management strategies for this hazardous shunt complication.

Area of Science:

  • Neurosurgery
  • Pediatric Surgery
  • Gastrointestinal Surgery

Background:

  • Ventriculo-peritoneal shunts are crucial for treating hydrocephalus in children.
  • Shunt malfunction, including bowel perforation and extrusion, is a rare but serious complication.
  • Understanding the pathogenesis and management of shunt extrusion is vital for patient safety.

Observation:

  • A 4-year-old child experienced peroral extrusion of the distal end of a fractured ventriculo-peritoneal shunt catheter.
  • The shunt tube had perforated the bowel, leading to its migration and externalization through the mouth.
  • This represents a unique and hazardous presentation of shunt complication.

Findings:

  • The fractured distal catheter was successfully removed via the cranial incision after dividing the shunt.
  • Surgical management involved accessing the shunt system through the existing cranial site for retrieval.
  • The patient's condition was successfully managed, with no reported immediate adverse events.

Implications:

  • This case underscores the importance of recognizing rare shunt complications and prompt surgical intervention.
  • Reviewing management strategies for ventriculo-peritoneal shunt peroral extrusion can improve clinical outcomes.
  • Further investigation into the pathogenesis of bowel perforation by shunt systems is warranted to prevent such occurrences.

Keywords:
Bowel perforationHydrocephalusOral extrusionVentriculo-perioneal shunt

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