A rare case of colon perforation complicating a vetriculoperitoneal shunt with trans-anal protrusion

Background: Ventriculoperitoneal (VP) shunt placement is an effective treatment of hydrocephalus diverting the cerebrospinal fluid into the peritoneal cavity. Colon perforation and spontaneous extrusion of the lower end of the tube through the anal opening is a rare and unusual complication of the ventriculoperitoneal shunt.

Case study: We report a case of 11 years old girl with the shunt tubing protruding through the anus associated with spontaneous colon perforation. This complication occurred 10 years following insertion of ventriculoperitoneal shunt for congenital hydrocephalus. There were no signs of meningitis and mild tenderness present over abdomen. At laparotomy the tube was seen to enter the descendens colon and
was encapsulated by the greater omentum. The tube was cut and the distal end removed via the anus. The
descendens colon was repaired. The catheter continued to function effectively and the patient remained
asymptomatic.

Conclusion: Colon perforation and transanal extrusion of VP shunt catheter is a rare but serious problem. The results of abdominal complications of VP shunts are excellent when diagnosed and treated early.