title: Uterine perforation by a cystoperitoneal shunt, an unusual cause of recurrent vaginal discharge.
abstract: BACKGROUND
  We describe the first reported case of uterine perforation by a cystoperitoneal shunt. The mechanism of this unusual complication is unclear.
  
  
  METHODS
  A 17-year-old patient had a cystoperitoneal shunt for a porencephalic cyst. She presented with recurrent watery vaginal discharge. A pelvic ultrasound examination showed that the uterus had been perforated by the distal tip of the shunt. The cystoperitoneal shunt was converted to a ventriculo-atrial shunt, and the vaginal discharge subsequently resolved.
  
  
  CONCLUSIONS
  The appearance of light and clear vaginal discharge in a patient with a cystoperitoneal shunt raises the possibility of uterine perforation. This can be confirmed by ultrasound and analysis of the discharge. Removal of the shunt leads to spontaneous closure of the uterine defect.
authors.affiliation: Department of Gynecologic Oncology, Notre-Dame Hospital, Montreal University Hospital, Montreal QC.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Poilblanc
authors.affiliation: Department of Obstetrics and Gynecology, Angers University Hospital, Angers Cedex, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Sentilhes
authors.affiliation: Department of Neurosurgery, Angers University Hospital, Angers Cedex, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Mercier
authors.affiliation: Department of Obstetrics and Gynecology, Angers University Hospital, Angers Cedex, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Lefèbvre
authors.affiliation: Department of Obstetrics and Gynecology, Angers University Hospital, Angers Cedex, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Descamps
mesh_terms: D000293:Adolescent; D002526:Cerebellar Diseases / Q000601:surgery*; D002531:Cerebellum / Q000002:abnormalities / Q000601:surgery; D005260:Female; D006801:Humans; D065708:Porencephaly; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014595:Uterine Perforation / Q000000981:diagnostic imaging / Q000209:etiology*; D019522:Vaginal Discharge / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*