title: Laparoendoscopic removal of peroral extrusion of a ventriculoperitoneal shunt.
abstract: BACKGROUND
  Ventriculoperitoneal shunts for hydrocephalic children are known to cause serious complications such as GI perforation. Peroral extrusion of the peritoneal part of a ventriculoperitoneal shunt is very rare, and management could be a challenge.
  
  
  METHODS
  An 11-year-old girl presented with peroral extrusion of the distal end of a ventriculoperitoneal shunt tube. Endoscopy and imaging studies showed that the peritoneal end had perforated the stomach and then extruded from the mouth. We used a surgical technique that combined endoscopy and laparoscopy to manage this rare complication.
  
  
  CONCLUSIONS
  Peroral extrusion of a ventriculoperitoneal shunt tube occurs secondary to perforation of the upper GI tract. Managing this condition involves removing the shunt tube, attention to the perforated viscus and associated infection. A combination of endoscopy and laparoscopy provided superior views, enabled identification of the site and size of the perforated viscus, and facilitated the uneventful removal of the tube.
authors.affiliation: Department of Paediatric Surgery, Waikato Hospital, Waikato, New Zealand.
authors.forename: Parkash
authors.initials: P
authors.lastname: Mandhan
authors.forename: Marilyn
authors.initials: M
authors.lastname: Wong
authors.forename: Udaya
authors.initials: U
authors.lastname: Samarakkody
mesh_terms: D002648:Child; D020878:Device Removal / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009055:Mouth; D013275:Stomach Rupture / Q000150:complications / Q000601:surgery*; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
keywords: Laparoendoscopy; ventriculoperitoneal shunts; viscus perforation