Anal Protrusion of Peritoneal End of Ventriculoperitoneal Shunt and Multiple Brain Abscesses: A Case Report With Review of Literature
Background and Importance: Ventriculoperitoneal shunt surgery is a widely accepted treatment for hydrocephalus, but it is not free from complications. Of all the complications, bowel perforation represents only 0.01-0.07% and it often presents with asymptomatic anal protrusion of the distal end of t...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Guilan University of Medical Sciences
2022-01-01
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| Series: | Iranian Journal of Neurosurgery |
| Subjects: | |
| Online Access: | http://irjns.org/article-1-305-en.html |
| _version_ | 1811222409046392832 |
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| author | Ahtesham Khizar Soha Zahid |
| author_facet | Ahtesham Khizar Soha Zahid |
| author_sort | Ahtesham Khizar |
| collection | DOAJ |
| description | Background and Importance: Ventriculoperitoneal shunt surgery is a widely accepted treatment for hydrocephalus, but it is not free from complications. Of all the complications, bowel perforation represents only 0.01-0.07% and it often presents with asymptomatic anal protrusion of the distal end of the ventriculoperitoneal shunt. The mechanism causing shunt ejection is unknown, but the most widely accepted theory is that after intestinal perforation, the tubing of the shunt is propelled out by the peristaltic movements in the gut.
Case Presantation: A case of a 3.5-year-old boy with anal protrusion of the peritoneal end of ventriculoperitoneal shunt and multiple brain abscesses is reported. In surgery, the ventriculoperitoneal shunt was divided at the clavicular region, and the peritoneal end was gently pulled out of the anus while the ventricular end was exteriorized. Empirical antibiotics, antiepileptics, and steroids were given. The culture and sensitivity report revealed no microorganisms. The child improved over a period of two weeks and then a new ventriculoperitoneal shunt was inserted on the opposite side.
Conclusion: Suspicion for bowel perforation must be kept high in symptomatic ventriculoperitoneal shunt patients even though most of the patients present with asymptomatic anal protrusion of the peritoneal end of ventriculoperitoneal shunt. In order to avoid infectious and neurological consequences, early identification and then subsequent treatment are crucial. The extruded end can easily be removed from the migrated orifice without the need for extensive surgery. |
| first_indexed | 2024-04-12T08:16:21Z |
| format | Article |
| id | doaj.art-2a8e80376bf54a17b69d7ea7d76cdb04 |
| institution | Directory Open Access Journal |
| issn | 2423-6497 2423-6829 |
| language | English |
| last_indexed | 2024-04-12T08:16:21Z |
| publishDate | 2022-01-01 |
| publisher | Guilan University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Neurosurgery |
| spelling | doaj.art-2a8e80376bf54a17b69d7ea7d76cdb042022-12-22T03:40:47ZengGuilan University of Medical SciencesIranian Journal of Neurosurgery2423-64972423-68292022-01-018155Anal Protrusion of Peritoneal End of Ventriculoperitoneal Shunt and Multiple Brain Abscesses: A Case Report With Review of LiteratureAhtesham Khizar0Soha Zahid1 Department of Neurosurgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan Department of Neurosurgery, Jinnah Medical and Dental College, Karachi, Pakistan Background and Importance: Ventriculoperitoneal shunt surgery is a widely accepted treatment for hydrocephalus, but it is not free from complications. Of all the complications, bowel perforation represents only 0.01-0.07% and it often presents with asymptomatic anal protrusion of the distal end of the ventriculoperitoneal shunt. The mechanism causing shunt ejection is unknown, but the most widely accepted theory is that after intestinal perforation, the tubing of the shunt is propelled out by the peristaltic movements in the gut. Case Presantation: A case of a 3.5-year-old boy with anal protrusion of the peritoneal end of ventriculoperitoneal shunt and multiple brain abscesses is reported. In surgery, the ventriculoperitoneal shunt was divided at the clavicular region, and the peritoneal end was gently pulled out of the anus while the ventricular end was exteriorized. Empirical antibiotics, antiepileptics, and steroids were given. The culture and sensitivity report revealed no microorganisms. The child improved over a period of two weeks and then a new ventriculoperitoneal shunt was inserted on the opposite side. Conclusion: Suspicion for bowel perforation must be kept high in symptomatic ventriculoperitoneal shunt patients even though most of the patients present with asymptomatic anal protrusion of the peritoneal end of ventriculoperitoneal shunt. In order to avoid infectious and neurological consequences, early identification and then subsequent treatment are crucial. The extruded end can easily be removed from the migrated orifice without the need for extensive surgery.http://irjns.org/article-1-305-en.htmlanal canalperitoneumventriculoperitoneal shuntbrain abscess |
| spellingShingle | Ahtesham Khizar Soha Zahid Anal Protrusion of Peritoneal End of Ventriculoperitoneal Shunt and Multiple Brain Abscesses: A Case Report With Review of Literature Iranian Journal of Neurosurgery anal canal peritoneum ventriculoperitoneal shunt brain abscess |
| title | Anal Protrusion of Peritoneal End of Ventriculoperitoneal
Shunt and Multiple Brain Abscesses: A Case Report
With Review of Literature |
| title_full | Anal Protrusion of Peritoneal End of Ventriculoperitoneal
Shunt and Multiple Brain Abscesses: A Case Report
With Review of Literature |
| title_fullStr | Anal Protrusion of Peritoneal End of Ventriculoperitoneal
Shunt and Multiple Brain Abscesses: A Case Report
With Review of Literature |
| title_full_unstemmed | Anal Protrusion of Peritoneal End of Ventriculoperitoneal
Shunt and Multiple Brain Abscesses: A Case Report
With Review of Literature |
| title_short | Anal Protrusion of Peritoneal End of Ventriculoperitoneal
Shunt and Multiple Brain Abscesses: A Case Report
With Review of Literature |
| title_sort | anal protrusion of peritoneal end of ventriculoperitoneal shunt and multiple brain abscesses a case report with review of literature |
| topic | anal canal peritoneum ventriculoperitoneal shunt brain abscess |
| url | http://irjns.org/article-1-305-en.html |
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