Bowel Perforation Caused by Peritoneal Shunt Catheters:Diagnosis and Treatment

Abstract

BPPC is a neurosurgical emergency. Anal extrusion is present in only a minority of patients; the diagnosis of BPPC is often difficult, delayed, and its incidence is likely underestimated. The majority of patients can be treated with a new peritoneal shunt after cure of the infection.

Bowel Perforatıon at The Delayed Stage After Shunt Surgery: Case Report

“…However, spontaneous bowel perforation is a rare complication from peritoneal catheter and its incidence is between 0.1-0.7% in shunted patients [2,3]. Bowel perforation may manifest immediately after surgery or several years later.…”

“…The ventriculitis, meningitis, intraabdominal abscess and generalized peritonitis that occur due to intestinal perforation are life-threating complications [3]. The most common presentation of bowel perforation is extrusion of catheter thorough anus [2][3][4][5][6]. Wilson et al [4] first reported an intestinal perforation induced by peritoneal catheter.…”

“…The delayed stage bowel perforation may result from a chronic inflammatory process. Exact pathogenesis of ventriculoperitoneal shuntrelated organ perforation is unclear and various mechanisms are suggested, such as foreign body reaction, pressure necrosis and poor general condition with weakening of intestinal wall and stiff end of shunt tube causing intestinal perforation [2][3][4][5][6][7][8].…”

“…Also authors have stated that unloaded silicon catheters, which do a foreign body-like reaction, are also responsible for bowel perforation [2,5,6]. Malnutrition may enhance chronic irritation and cause intestinal perforation.…”

“…Spontoneous bowel perforation by peritoneal catheter is rare. However, this delayed complications may cause fatal ventriculit, meningitis, or sepsis [1][2][3][4][5][6][7][8]. Diagnosis of bowel perforation is self-evident when the catheter protrudes thorough the anus.…”