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Multiple subdural abscesses following colonic perforation--a rare complication of a ventriculoperitoneal shunt
1Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abstract:
A case of colonic perforation by a ventriculoperitoneal shunt, its subsequent migration and protrusion from the anal orifice is reported. The shunt reservoir and ventricular catheter were removed percutaneously, and the disconnected peritoneal catheter was pulled out through the anus. Blood culture grew Klebsiella pneumoniae and Streptococcus fecalis. CT scan showed multiple subdural abscesses with evidence of ventriculitis. Removal of the shunt (as described), evacuation of subdural pus and systemic antibiotics resulted in complete recovery.
Insights
A rare case of colonic perforation by a ventriculoperitoneal shunt is presented. The shunt migrated through the anus, but surgical removal and antibiotics led to full recovery.
Area of Science:
- Neurosurgery
- Gastroenterology
- Infectious Diseases
Background:
- Ventriculoperitoneal shunts are used to treat hydrocephalus.
- Complications can include shunt malfunction and infection.
Observation:
- A ventriculoperitoneal shunt perforated the colon.
- The shunt migrated and protruded from the anal orifice.
- Subdural abscesses and ventriculitis were identified on CT scan.
Findings:
- The shunt reservoir and ventricular catheter were removed percutaneously.
- The peritoneal catheter was removed via the anus.
- Blood cultures identified Klebsiella pneumoniae and Streptococcus fecalis.
- Treatment included shunt removal, pus evacuation, and antibiotics.
Implications:
- This case highlights a rare but serious complication of ventriculoperitoneal shunts.
- Prompt diagnosis and multidisciplinary management are crucial for favorable outcomes.
- Highlights the importance of considering unusual shunt migration pathways.