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Child's Nervous System

, Volume 34, Issue 5, pp 805–807 | Cite as

Does a systematic algorithm matter for the management of ventriculoperitoneal shunt perforations of the gastrointestinal tract?

  • Sofiene Bouali
  • Khalil Ghedira
  • Hela Mnakri
  • Jalel Kallel
  • Hafedh Jemel
Letter to the Editor

Dear Editor:

The gastrointestinal tract perforation is a rare complication of ventriculoperitoneal shunt, occurring in 0.1–0.7% of patients and can be fatal if unrecognized [1].

There have been less than 100 reports on migration of the distal catheter of the ventriculoperitoneal shunt to rectal orifice since this phenomenon was recognized 50 years ago, out of which 50% were children below 15 years of age [2, 3].

Colon is the most frequent site of perforation and clinical manifestations can be variable and nonspecific. Patients can be asymptomatic or may present with abdominal pain, rectal extrusion of the tubing, fever, diarrhea, shunt dysfunction, meningitis, or seizures [4].

The pathogenesis which was described as plausible explanations to the etiology of bowel perforation was related to adherence, and constant pressure of the catheter tip to the wall of viscera with local inflammatory reaction leads to erosion of the visceral wall and entrance of tip in the lumen [3].

Thin bowel...

Notes

Compliance with ethical standards

Conflict of interest

None of the authors has any potential conflict of interest.

References

  1. 1.
    Alves AR, Mendes S, Lopes S, Monteiro A, Perdigoto D, Amaro P, Tomé L (2017) Endoscopic management of colonic perforation due to ventriculoperitoneal shunt: case report and literature review. GE Port J Gastroenterol 24:232–236CrossRefPubMedPubMedCentralGoogle Scholar
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    Allouh MZ, Al Barbarawi MM, Asfour HA, Said RS (2017) Migration of the distal catheter of the ventriculoperitoneal shunt in hydrocephalus: a comprehensive analytical review from an anatomical perspective. Clin Anat 30(6):821–830CrossRefPubMedGoogle Scholar
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    Borkar SA, Mahapatra AK (2012) Ventriculoperitoneal shunt catheter protrusion through the anus. Childs Nerv Syst 28:341–342.  https://doi.org/10.1007/s00381-012-1684-1 CrossRefPubMedGoogle Scholar
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    Bourm K, Pfeifer C, Zarchan A (2016) Small bowel perforation: a rare complication of ventriculoperitoneal shunt placement. Radiology Case 10(6):30–35.  https://doi.org/10.3941/jrcr.v10i6.2721 CrossRefPubMedPubMedCentralGoogle Scholar
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    Thiong’o GM, Luzzio C, Albright AL (2015) Ventriculoperitoneal shunt perforations of the gastrointestinal tract. J Neurosurg Pediatr 16:36–41CrossRefPubMedGoogle Scholar
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    Bales J, Morton RP, Airhart N, Flum D, Avellino AM (2016) Transanal presentation of a distal ventriculoperitoneal shunt catheter: management of bowel perforation without laparotomy. Surg Neurol Int 7(Suppl 44):S1150–S1153.  https://doi.org/10.4103/2152-7806.196930 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Sofiene Bouali
    • 1
  • Khalil Ghedira
    • 1
  • Hela Mnakri
    • 1
  • Jalel Kallel
    • 1
  • Hafedh Jemel
    • 1
  1. 1.Department of Neurosurgery, National Institute of Neurology Tunis “Mongi Ben Hmida”, Tunis Faculty of MedicineUniversity of Tunis El ManarTunisTunisia

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