Does a systematic algorithm matter for the management of ventriculoperitoneal shunt perforations of the gastrointestinal tract?
The gastrointestinal tract perforation is a rare complication of ventriculoperitoneal shunt, occurring in 0.1–0.7% of patients and can be fatal if unrecognized .
There have been less than 100 reports on migration of the distal catheter of the ventriculoperitoneal shunt to rectal orifice since this phenomenon was recognized 50 years ago, out of which 50% were children below 15 years of age [2, 3].
Colon is the most frequent site of perforation and clinical manifestations can be variable and nonspecific. Patients can be asymptomatic or may present with abdominal pain, rectal extrusion of the tubing, fever, diarrhea, shunt dysfunction, meningitis, or seizures .
The pathogenesis which was described as plausible explanations to the etiology of bowel perforation was related to adherence, and constant pressure of the catheter tip to the wall of viscera with local inflammatory reaction leads to erosion of the visceral wall and entrance of tip in the lumen .
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Conflict of interest
None of the authors has any potential conflict of interest.
- 6.Bales J, Morton RP, Airhart N, Flum D, Avellino AM (2016) Transanal presentation of a distal ventriculoperitoneal shunt catheter: management of bowel perforation without laparotomy. Surg Neurol Int 7(Suppl 44):S1150–S1153. https://doi.org/10.4103/2152-7806.196930 CrossRefPubMedPubMedCentralGoogle Scholar