title: Bladder perforation by ventriculoperitoneal shunt.
abstract: BACKGROUND
  Bladder perforation by ventriculoperitoneal shunt is a rare complication that has been describe in 19 cases in prior literature.
  
  
  METHODS
  This work describes the case of a 4-month-old baby who presented with extrusion of the distal catheter through the urethra. The patient underwent a laparotomy; the catheter was cut close to the bladder wall and repositioned into the peritoneal cavity. The bladder wall was sutured, and the remaining distal portion of the catheter was removed through the urethra.
  
  
  CONCLUSIONS
  Based on this single experience and a literature review, the authors classified the clinical signs and symptoms of bladder perforation by the ventriculoperitoneal shunt catheter. Finally, the authors propose a more conservative approach for this rare complication.
authors.affiliation: Department of Surgery, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.|Service of Pediatric Surgery, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Marcelo Eller
authors.initials: ME
authors.lastname: Miranda
authors.affiliation: Service of Pediatric Surgery, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Mariana Bueno
authors.initials: MB
authors.lastname: de Sousa
authors.affiliation: Department of Surgery, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.|Service of Pediatric Surgery, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Edson Samesima
authors.initials: ES
authors.lastname: Tatsuo
authors.affiliation: Service of Neurosurgery, Hospital das Clínicas, Federal University of Minas Gerais, Rua Santa Catarina, 1042 ap: 201, Belo Horizonte, MG, 30170-080, Brazil.
authors.forename: Lucas Viana
authors.initials: LV
authors.lastname: Quites
authors.affiliation: Department of Surgery, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil. agjg@terra.com.br.|Service of Neurosurgery, Hospital das Clínicas, Federal University of Minas Gerais, Rua Santa Catarina, 1042 ap: 201, Belo Horizonte, MG, 30170-080, Brazil. agjg@terra.com.br.
authors.forename: Alexandre Varella
authors.initials: AV
authors.lastname: Giannetti
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D001743:Urinary Bladder / Q000293:injuries*; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
keywords: Bladder; Complication; Hydrocephalus; Ventriculoperitoneal shunt