Indian Journal of Neurosurgery 2016; 05(03): 196-201
DOI: 10.1055/s-0036-1584586
Case Report
Thieme Medical and Scientific Publishers Private Ltd.

Peroral Extrusion of Ventriculoperitoneal Shunt: An Unusual Complication and Review of Literature

Ankit S. Shah
1   Department of Neurosurgery, G. B. Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
,
Daljit Singh
1   Department of Neurosurgery, G. B. Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
,
Poonam Loomba
2   Department of Microbiology, G. B. Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
,
Hukum Singh
1   Department of Neurosurgery, G. B. Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
,
Amit Mittal
1   Department of Neurosurgery, G. B. Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
,
Siddharth Srivastava
3   Department of Gastroenterology, G. B. Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
› Institutsangaben
Weitere Informationen

Publikationsverlauf

05. Februar 2016

11. März 2016

Publikationsdatum:
02. November 2016 (online)

Abstract

Several case reports regarding complications of ventriculoperitoneal (VP) shunt have been published, but peroral extrusion of shunt tube is unusual and reported less frequently. A 4-year-old male child with previous history of VP shunt insertion for congenital hydrocephalus along with shunt revisions twice presented with peritoneal end of shunt tube protruding through the mouth following an acute episode of vomiting. He was conscious without any signs of infection or neurologic deficits. The distal portion of the tube was removed uneventfully with the help of upper GI endoscope that, in addition to removal, provided better views for the identification of site and size of perforation. Peroral extrusion of the shunt tube needs immediate treatment that includes removal of extruded shunt tube, treatment of underlying infection, and attention to perforated viscus. We review the possible pathogenesis of this entity and various treatment options.

 
  • References

  • 1 Park CK, Wang KC, Seo JK, Cho BK. Transoral protrusion of a peritoneal catheter: a case report and literature review. Childs Nerv Syst 2000; 16 (3) 184-189
  • 2 Low SW, Sein L, Yeo TT, Chou N. Migration of the abdominal catheter of a ventriculoperitoneal shunt into the mouth: a rare presentation. Malays J Med Sci 2010; 17 (3) 64-67
  • 3 Mandhan P, Wong M, Samarakkody U. Laparoendoscopic removal of peroral extrusion of a ventriculoperitoneal shunt. Asian J Endosc Surg 2015; 8 (1) 95-97
  • 4 Hai A, Rab AZ, Ghani I, Huda MF, Quadir AQ. Perforation into gut by ventriculoperitoneal shunts: a report of two cases and review of the literature. J Indian Assoc Pediatr Surg 2011; 16 (1) 31-33
  • 5 Odebode TO. Jejunal perforation and peroral extrusion of a peritoneal shunt catheter. Br J Neurosurg 2007; 21 (2) 235-236
  • 6 Sridhar K, Karmarkar V. Peroral extrusion of ventriculoperitoneal shunt: case report and review of literature. Neurol India 2009; 57 (3) 334-336
  • 7 Agarwal M, Adhana R, Namdev H, Yadav YR, Agrawal T. Transoral extrusion of the ventriculo-peritoneal shunt: a case report and review of literature. J Pediatr Neurosci 2011; 6 (2) 149-151
  • 8 Brownlee JD, Brodkey JS, Schaefer IK. Colonic perforation by ventriculoperitoneal shunt tubing: a case of suspected silicone allergy. Surg Neurol 1998; 49 (1) 21-24
  • 9 Yilmaz MB, Egemen E, Tonge M, Kaymaz M. Transoral protrusion of a peritoneal catheter due to gastric perforation 10 years after a ventriculoperitoneal shunting: case report and review of the literature. Turk Neurosurg 2013; 23 (2) 285-288
  • 10 Griffith JA, DeFeo D. Peroral extrusion of a ventriculoperitoneal shunt catheter. Neurosurgery 1987; 21 (2) 259-261
  • 11 Fermin S, Fernández-Guerra RA, Sureda PJ. Extrusion of peritoneal catheter through the mouth. Childs Nerv Syst 1996; 12 (9) 553-555
  • 12 Kothari PR, Shankar G, Kulkarni B. Extruded ventriculo-peritoneal shunt: an unusual complication. J Indian Assoc Pediatr Surg 2006; 11 (4) 255-256
  • 13 Murali R, Ravikumar V. Transoral migration of peritoneal end of ventriculoperitoneal shunt: a case report of a rare complication and review of literature. J Pediatr Neurosci. 2008; 3 (2) 166-168
  • 14 Gupta M, Digra NC, Sharma N, Goyal S, Agrawal A. Peroral extrusion of the peritoneal catheter in an infant. N Am J Med Sci 2012; 4 (6) 290-292
  • 15 Sathyanarayana S, Wylen EL, Baskaya MK, Nanda A. Spontaneous bowel perforation after ventriculoperitoneal shunt surgery: case report and a review of 45 cases. Surg Neurol 2000; 54 (5) 388-396