title: Transanal prolapse of a ventriculoperitoneal shunt catheter--case report.
abstract: A 4-year-old girl presented with asymptomatic bowel perforation and transanal protrusion of a ventriculoperitoneal (VP) shunt catheter. She had undergone repair of myelomeningocele at birth and subsequent VP shunting for congenital hydrocephalus 1 month later. Seven months after VP shunting, she underwent revision of the peritoneal catheter. She complained of abdominal pain and nausea at the age of 4 years. She was treated conservatively for 1 month for intestinal obstruction. One month later, her mother noticed the shunt catheter protruding from her anus. Computed tomography (CT) of the abdomen revealed that the peritoneal catheter had migrated into the colon, and CT of the head showed symmetrical dilation of the ventricles. The shunt system was removed immediately, repair of the fistula in the sigmoid colon was performed, and external ventricular drainage was continued for 6 weeks until shunt replacement. One month after the first operation, intestinal obstruction recurred. Duplication of the terminal ileum was removed to prevent further recurrence of the intestinal obstruction. She underwent ventriculoatrial shunting 2 weeks after the second operation and was discharged without neurological sequelae.
authors.affiliation: Department of Neurosurgery, Kyoto First Red Cross Hospital.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Matsuoka
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Takegami
authors.forename: Daisuke
authors.initials: D
authors.lastname: Maruyama
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Hamasaki
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Kakita
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Mineura
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000015:Abnormalities, Multiple / Q000601:surgery; D001003:Anal Canal; D002404:Catheterization / Q000009:adverse effects*; D002557:Cerebrospinal Fluid Shunts; D002675:Child, Preschool; D020878:Device Removal; D005260:Female; D005548:Foreign-Body Migration / Q000601:surgery*; D006325:Heart Atria; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007077:Ileal Diseases / Q000209:etiology; D007082:Ileum / Q000002:abnormalities; D007412:Intestinal Fistula / Q000209:etiology* / Q000601:surgery; D007415:Intestinal Obstruction / Q000209:etiology; D007416:Intestinal Perforation / Q000209:etiology* / Q000601:surgery; D008591:Meningomyelocele / Q000601:surgery; D012008:Recurrence; D012810:Sigmoid Diseases / Q000209:etiology* / Q000601:surgery; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects* / Q000295:instrumentation