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. 2021 Jun:83:106059.
doi: 10.1016/j.ijscr.2021.106059. Epub 2021 May 29.

Duodenal perforation as a postoperative complication after ventriculoperitoneal shunt: A case report

He Van Dong  1 , Hanh Duc Van  1 , Hieu Tri Vu  2 , Hung Thanh Chu  3
Affiliations

Duodenal perforation as a postoperative complication after ventriculoperitoneal shunt: A case report

He Van Dong et al. Int J Surg Case Rep. 2021 Jun.

Abstract

Introduction and importance: Ventriculoperitoneal shunt (VP shunt) is the one of the most common and important tools for the treatment of hydrocephalus. It requires simple technique and demonstrates effectiveness in treating hydrocephalus. However, many complications have been reported such as infection, valve obstruction, valve dysfunction and abdominal complications. Complications of intestinal perforation and catheter penetrating the intestine are very rare, accounting for 0.01-0.07% of abdominal complications. In the literature, 94 cases of intestinal perforation and catheter penetration and only 2 cases of duodenal perforation have been reported.

Case presentation: In this study, we report a successful surgical treatment of a duodenal perforation complication after 5 months of VP shunt. Gastroscopy showed the distal tip penetrating into the D2 segment of the duodenum. Surgery was performed to relocate the abdominal tip and to repair the perforation. Meningitis was treated with antibiotics. The patient was stable and discharged after 3 weeks.

Clinical discussion: The epidermiology, presentation and diagnosis and strategy of treatments as well as their outcomes were discussed.

Conclusion: Intestinal perforation with VP shunt catheter is rare. Diagnosis is simple if the catheter comes out of the anus, mouth, vagina, penis, scrotum, navel. In case when the catheter is inside the lumen of the gastrointestinal tract, diagnosis often requires imaging such as abdominal computed tomography, and gastrointestinal endoscopy. Surgery treatment was to replace the drainage valve and to close the perforation the digestive tract.

Keywords: Abdominal complication; Duodenum perforation; Ventriculo-peritoneal shunt.

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Conflict of interest statement

The authors declared no conflict of interest.

Figures

Fig. 1
Fig. 1
Cranial CT scan after VP shunt. The catheter was inside the ventricles. The ventricles were not dilated.
Fig. 2
Fig. 2
The gastroscopy images. A: The location where the catheter entered the duodenum. Noted the fibrosis around the location. B: The distal catheter inside the duodenum was shown.
Fig. 3
Fig. 3
Intra-operative image. The distal tip entering the duodenum was shown.
See this image and copyright information in PMC

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