Webster Andrew, Singh Rishabh, Stebbing John
General Surgery, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
General Surgery, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK.
BMJ Case Rep. 2021 Apr 1;14(4):e240634. doi: 10.1136/bcr-2020-240634.
We report the case of a 48-year-old man with spina bifida and history of previous ventriculoperitoneal (VP) shunt placement for hydrocephalus. On attempted removal of the shunt 2 years prior to presentation at a neurosurgical unit, the peritoneal component was left in situ due to difficulties with removal. He presented acutely to our general surgical department with an enterocutaneous fistula precipitated by the retained fragment discharging to the right upper abdominal quadrant that required urgent surgical intervention. Although abdominal complications of VP shunts are documented, there is minimal literature as to the risks of remnant catheters being left in situ. This case demonstrates the possible risks with retained VP shunt catheters and the necessity to remove any redundant foreign bodies to prevent significant delayed complications.
我们报告了一例48岁男性病例,该患者患有脊柱裂,既往因脑积水接受过脑室腹腔(VP)分流术。在本次于神经外科就诊前2年试图取出分流管时,由于取出困难,腹腔部分被留在原位。他因残留碎片排入右上腹象限导致肠皮肤瘘而紧急就诊于我们的普通外科,需要紧急手术干预。尽管VP分流术的腹部并发症已有文献记载,但关于残留导管留在原位的风险的文献却很少。本病例展示了保留VP分流管导管可能存在的风险,以及移除任何多余异物以防止严重延迟并发症的必要性。