{"id":"eef23ddd-45fa-47ed-9483-363e002bccd9","slug":"transanal-presentation-of-a-distal-ventriculoperitoneal-shunt-catheter-management-of-bowel-perforation-without-laparotomy","title":"Transanal presentation of a distal ventriculoperitoneal shunt catheter: Management of bowel perforation without laparotomy","authors":["James Bales","Ryan P. Morton","Nathan Airhart","David Flum","Anthony M. Avellino"],"abstract":"Background: Bowel perforation is a serious but rare complication after a ventriculoperitoneal shunt (VPS) procedure. Prior studies have reported spontaneous bowel perforation after VPS placement in adults of up to 0.07%. Transanal catheter protrusion is a potential presentation of VPS bowel perforation and places a patient at risk for both peritonitis and ventriculitis/meningitis via retrograde migration of bacteria. This delayed complication can be fatal if unrecognized, with a 15% risk of mortality secondary to ventriculitis, peritonitis, or sepsis. Case Description: We describe a unique case of a patient with distal VPS catheter protrusion from the anus whose bowel perforation did not cause clinical sequelae of infection. We were able to manage the patient without laparotomy. Conclusions: A subset of patients can be managed without laparotomy and only with externalization of the ventricular shunt with antibiotics until the cerebrospinal fluid cultures finalize without growth.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/eef23ddd-45fa-47ed-9483-363e002bccd9/featured/hero-1782420886526.png","publishDate":"2016-12-28T00:00:00.000Z","doi":"10.4103/2152-7806.196930","categories":["Pediatric Neurosurgery","Case Report"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2017/01/8248/SNI-7-1150.pdf"}