Gastric perforation due to ventriculo-peritoneal shunt.

Gastric perforation is a complication that can arise from ventriculo-peritoneal (VP) shunting. Careful examination of a newborn girl admitted to our department revealed several neurological problems. A VP shunt was inserted under direct visualization, leaving 20 cm of the catheter in the peritoneal cavity. The infant was discharged 6 days after surgery and readmitted 4 months later due to increasing head circumference and severe malnutrition. Physical examination revealed a soft abdomen, normal peristalsis, and no signs of peritoneal irritation. The patient was submitted to exploratory surgery, which showed that the catheter had penetrated about 6 cm into the stomach. The VP shunt was removed and replaced by a left ventriculo-atrial system. The patient evolved well and was discharged 5 days later. Probable causes of the perforation are discussed in this paper.