Small bowel perforation: a rare complication of ventriculoperitoneal shunt placement

Area of Science:

• Pediatric Surgery
• Neurosurgery
• Gastroenterology

Background:

• Ventriculoperitoneal (VP) shunts are common in treating hydrocephalus.
• Small bowel perforation is an infrequent but serious complication of VP shunt placement.
• Gastric or colonic perforation are more typical presentations than small bowel involvement.

Purpose of the Study:

• To report a rare case of small bowel perforation due to VP shunt erosion in a pediatric patient.
• To describe the characteristic imaging findings associated with this complication.
• To review the existing literature on VP shunt-induced gastrointestinal perforations.

Main Methods:

• Case presentation of an 8-year-old female with sepsis.
• Review of diagnostic imaging (e.g., CT, X-ray) findings.
• Surgical confirmation of shunt erosion into the small bowel.
• Literature search for similar reported cases.

Main Results:

• The patient presented with sepsis secondary to VP shunt malposition.
• Imaging revealed erosion of the VP shunt into the small bowel.
• Surgical exploration confirmed the shunt's intra-luminal position within the small intestine.
• Literature review identified limited but similar cases.

Conclusions:

• Small bowel perforation is a rare but critical complication of VP shunts.
• Prompt diagnosis via imaging and surgical intervention are crucial for management.
• Understanding atypical presentations like small bowel involvement is important for clinicians.