Awwad Ahmad R, S H Odeh Manar, Asad Diya, Y M H Abu Rmeileh Basel, M M Dweik Aya, N M Baraka Saja, A F Karami Malek, I M Awad Iyas, W M Jobran Afnan
General Practice, Rafidia Governmental Hospital, Nablus, PSE.
Medicine, Faculty of Medicine, Al-Quds University, Jerusalem, PSE.
Cureus. 2024 Jan 15;16(1):e52334. doi: 10.7759/cureus.52334. eCollection 2024 Jan.
A ventriculoperitoneal (VP) shunt is a connection between the cerebral ventricles and the peritoneal cavity. One of the rare complications of this procedure is shunt migration and perforation of the bowel. Our case report presents the case of a 19-month-old male patient who underwent VP shunt insertion due to hydrocephalus at the age of 8 months. He suffered from two episodes of bacterial meningitis at the ages of 11 and 15 months, requiring hospital admission. The patient's parents brought him to the emergency department after noticing a blood-stained diaper and seeing a part of the shunt extruding from the anal opening. Upon physical examination, the patient was active, neither in distress nor tachycardic. with unremarkable abdominal examination and negative peritoneal signs. A digital rectal examination showed normal anal tone, with normal-coloured stool with no blood at the tip of the finger, together with a compressible VP shunt. Complications of this type of migration include faecal contamination and possible infections such as ascending meningitis. This case report highlights the extrusion of the shunt through the anal orifice in a 19-month-old male patient which serves as an example of the uncommon but serious consequence of VP shunt insertion in the pediatric population. While VP shunt insertion remains a widely used and effective treatment for hydrocephalus, healthcare providers need to recognize and address potential complications associated with this procedure. Additionally, this case emphasizes the importance of diligent monitoring and regular radiographic imaging to confirm the correct positioning of shunt components, particularly in the paediatric population.
脑室腹腔(VP)分流术是脑室与腹腔之间的一种连接方式。该手术罕见的并发症之一是分流管移位和肠穿孔。我们的病例报告介绍了一名19个月大的男性患者,他在8个月大时因脑积水接受了VP分流管植入手术。他在11个月和15个月大时患过两次细菌性脑膜炎,需要住院治疗。患者的父母在发现尿布上有血迹并看到分流管的一部分从肛门开口处伸出后,将他带到了急诊科。体格检查时,患者活动自如,既无痛苦也无心动过速。腹部检查无异常,腹膜征阴性。直肠指检显示肛门括约肌张力正常,大便颜色正常,手指尖无血迹,同时可触及VP分流管。这种移位类型的并发症包括粪便污染和可能的感染,如上行性脑膜炎。本病例报告突出了一名19个月大男性患者的分流管经肛门孔道挤出的情况,这是小儿人群中VP分流管植入术虽不常见但严重后果的一个例子。虽然VP分流管植入术仍然是治疗脑积水广泛使用且有效的方法,但医疗服务提供者需要认识并处理与该手术相关的潜在并发症。此外,该病例强调了仔细监测和定期进行影像学检查以确认分流管组件正确位置的重要性,特别是在小儿人群中。