A B S T R A C TVentriculoperitoneal (VP) shunt is a common procedure performed in the management of hydrocephalus in children. The peritoneal end of the shunt can migrate in the peritoneal cavity and extrude through the mouth, umbilicus, anus, vagina or urethra after injuring the overlying structures. Timely removal is necessary to prevent transmission of infection. We are reporting a case in which there is extrusion of shunt per urethra.

Background: Intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction. It is often a diagnostic dilemma and a high degree of suspicion is required to make an early and accurate diagnosis in children. Case Report: A 2-year-old child presented with bilious vomiting and abdominal distension. X-ray abdomen showed high intestinal obstruction. Ultrasound and CT scan abdomen gave suspicion of pancreatic pseudo-cyst near head of pancreas. At surgery, an intramural hematoma of the duodenum was found and drained. Conclusion: Intramural duodenal hematoma is a rare entity especially in children and should be considered in differential diagnosis of acquired duodenal obstruction.