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Penetration of the colon by a ventriculo-peritoneal drain resulting in an intra-cerebral abscess
Insights
A ventriculo-peritoneal shunt malfunctioned in an infant due to intestinal perforation, leading to a cerebral abscess and death. This case highlights the rare but severe complication of shunt misplacement.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Medical Device Complications
Background:
- Hydrocephalus is a condition characterized by excess cerebrospinal fluid in the brain.
- Aqueductal stenosis is a common cause of congenital hydrocephalus.
- Ventriculo-peritoneal shunts are surgically implanted devices to treat hydrocephalus.
Observation:
- A male infant presented with hydrocephalus requiring a ventriculo-peritoneal shunt shortly after birth.
- Post-shunt placement, the hydrocephalus worsened.
- Autopsy revealed the shunt's peritoneal tip had perforated the transverse colon.
Findings:
- The cerebral tip of the shunt was found within a large abscess in the right cerebral hemisphere.
- Intestinal perforation by a ventriculo-peritoneal catheter is a rare complication.
- Ascending infection from intestinal perforation can lead to fatal outcomes.
Implications:
- This case underscores the critical importance of accurate shunt placement and monitoring.
- Early detection and management of shunt complications are vital in pediatric neurosurgery.
- Understanding rare complications like intestinal perforation can improve patient safety and surgical techniques.
Abstract:
A male child was born with internal hydrocephalus due to aqueductal stenosis requiring a ventriculo-peritoneal shunt on the first postnatal day. Subsequently, the hydrocephalus did not subside but increased. Autopsy at the age of 15 months disclosed the peritoneal tip of the catheter located inside the transverse colon, the cerebral tip of the catheter within a huge abscess of the right cerebral hemisphere. Penetration of the intestine by a ventriculo-peritoneal catheter seems to be a rare event, occasionally resulting in early death due ascending infection.