Journal of Universal Surgery

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Asymptomatic Migration of Ventriculoperitoneal Shunt Tube through the Anus

Amer Hashim Al-Ani*, Mariam Eisa Alhosani and Kholoud Mohammed Aljabberi

Introduction: Hydrocephalus is caused by the inability of Cerebrospinal Fluid (CSF) to drain into the bloodstream. Ventriculoperitoneal shunt (VP shunt) is used frequently in the treatment of Hydrocephalus. VP shunt complications are common.

Case presentation: A 4-year-old girl had VP shunt at the age of one year. Her mother noticed a tube protruded through her anus and brought her to the emergency department. Laparotomy revealed the VP shunt tube inside the peritoneal cavity. Its distal end penetrated the recto- sigmoid junction and passed into the anus. The penetrating part of the shunt was cut and removed. The perforated bowel was repaired.

Discussion: VP shunt is a commonly performed procedure. It is associated with a high rate of complication. The incidence of bowel perforation with protrusion of VP shunt per anus is a rare complication. This complication is serious.

Conclusion: Migration of VP shunt tube through the anus is rare. It may happen without symptoms. It can be prevented by proper technique and length of tube. The proper treatment is removal of the migrated part and closure of the perforated bowel by laparotomy or laparoscopy.