Alves Ana Rita, Mendes Sofia, Lopes Sandra, Monteiro Alexandre, Perdigoto David, Amaro Pedro, Tomé Luís
Gastroenterology Department, Coimbra Hospital and University Centre, Coimbra, Portugal.
General Surgery A Department, Coimbra Hospital and University Centre, Coimbra, Portugal.
GE Port J Gastroenterol. 2017 Sep;24(5):232-236. doi: 10.1159/000454987. Epub 2017 Feb 8.
The authors report the case of a 41-year-old woman with a colonic perforation due to a ventriculoperitoneal shunt (VPS) catheter. Left-sided colonic perforation was diagnosed by abdominal computed tomography 28 years after shunt placement, following acute meningitis caused by . The proximal end of the VPS was exteriorized and it was decided to remove the distal end by colonoscopy. After pulling out the catheter with a polypectomy snare, it broke at the site where it was entering the colon, leaving a small perforation in the colonic wall which was closed with 2 endoclips. The endoluminal fragment of the catheter, being 20 cm in length, was removed through the rectum. The patient is asymptomatic at the 12-month follow-up. A review of the literature regarding 9 endoscopically managed cases of digestive tract perforation caused by VPS is presented.
作者报告了一例41岁女性因脑室腹腔分流术（VPS）导管导致结肠穿孔的病例。在分流术后28年，因[此处原文缺失导致脑膜炎的病因]引发急性脑膜炎后，通过腹部计算机断层扫描诊断为左侧结肠穿孔。VPS的近端已外露，决定通过结肠镜切除远端。用息肉切除圈套器拔出导管后，它在进入结肠的部位断裂，在结肠壁上留下一个小穿孔，用2个内镜夹封闭。导管的腔内碎片长20厘米，通过直肠取出。在12个月的随访中，患者无症状。本文还对9例经内镜处理的VPS导致消化道穿孔的病例进行了文献综述。
