Colonic perforation as a complication of ventriculoperitoneal shunt: two case reports with a literature review

Abstract

A ventriculoperitoneal (VP) shunt is a commonly performed treatment modality for hydrocephalus. The VP shunt-related complications include infection (peritonitis, ventriculitis, and meningitis), obstruction, migration, and perforation of the intestine [1,2]. Shunt devices have a high incidence of malfunction mainly due to catheter obstruction or infection and are associated with various complications, 25% of which are abdominal complications [3]. Spontaneous bowel perforation is a rare complication with an incidence of 0.01% to 0.07% in VP shunt procedures, occurring at any time, including a few weeks to several years after the placement of the VP shunt device [4]. Treatment must be individualized and depends upon the clinical presentation. Conservative management, endoscopy, and surgery have been performed for the treatment of bowel-related complications from a VP shunt device [5,6]. We report cases of a 79-year-old female and a 49-year-old male with colonic perforations due to migrated VP shunts that were successfully treated by the colonoscopic removal of the migrated distal catheter and hemoclipping of the perforated colonic wall, Colonic perforation as a complication of ventriculoperitoneal shunt: two case reports with a literature review