单纯性脑室腹腔分流术后8年出现经直肠导管侵蚀：病例说明
Catheter erosion through the rectum 8 years after uncomplicated ventriculoperitoneal shunt placement: illustrative case.
作者信息
Wierzbicki Matthew, Shelley India, Lan Matthews, Mahtabfar Aria, Farrell Christopher J
机构信息
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
出版信息
J Neurosurg Case Lessons. 2025 Sep 1;10(9). doi: 10.3171/CASE25365.
BACKGROUND
Distal bowel perforation by peritoneal catheter (BPPC) is a rare complication following ventriculoperitoneal shunt (VPS) placement for the treatment of hydrocephalus. In some cases, BPPC may present with extrusion through the anus and can occur years after VPS placement.
OBSERVATIONS
The authors report the case of a 30-year-old woman who had a VPS placed 8 years prior and found a catheter protruding from her rectum. Having pulled out 1 foot of catheter, she presented to the hospital where the shunt was externalized before concurrent VPS removal and laparotomy to repair the bowel perforation.
LESSONS
BPPC with anal extrusion is a rare complication of VPS that can occur years after shunt placement and can present with a broad array of symptoms. BPPC should remain on the differential for people with VPS and systemic symptoms for the duration of their lives. https://thejns.org/doi/10.3171/CASE25365.
背景
腹膜导管导致的远端肠穿孔（BPPC）是脑室腹腔分流术（VPS）治疗脑积水后一种罕见的并发症。在某些情况下，BPPC可能表现为经肛门挤出，且可在VPS置入数年之后发生。
观察结果
作者报告了一例30岁女性病例，该患者8年前接受了VPS置入术，现发现有导管从直肠突出。在拔出1英尺长的导管后，她前往医院就诊，在那里先将分流管外置，然后同时移除VPS并进行剖腹手术以修复肠穿孔。
经验教训
伴有经肛门挤出的BPPC是VPS一种罕见的并发症，可在分流术后数年发生，且可表现出多种症状。对于接受VPS治疗且有全身症状的患者，在其一生中都应将BPPC纳入鉴别诊断范围。https://thejns.org/doi/10.3171/CASE25365
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