Transoral Protrusion of a Ventriculoperitoneal Catheter Caused by Jejunal Perforation in an Adult: Rare Case Report and Review of the Literature

Feeney, Vincent; Ansar, Naufel; Donaldson-Hugh, Beth; Alalade, Andrew F.

doi:10.1016/j.wneu.2020.02.009

Cited by 9 publications

(9 citation statements)

References 29 publications

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“…10,11,[33][34][35] Trans-oral extrusion of the distal VPS catheter has also been reported in approximately 30 cases to date. 11,12,33,36,37 The extrusion of the distal VPS catheter through the vaginal orifice has also been reported but is less frequent than all the above extrusions. In 1973, Patel et al first-time reported trans-vaginal extrusion of the distal VPS catheter in a child, and since then, only 20 such cases have been reported to date.…”

Section: Discussionmentioning

confidence: 99%

Management of trans-vaginal extrusion of the distal ventriculoperitoneal shunt catheter: a systematic literature review from 1973 to 2021

Ghritlaharey

2021

Int J Res Med Sci

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Trans-vaginal extrusion of the distal ventriculoperitoneal shunt (VPS) catheter is a rare complication of VPS insertion done for the treatment of hydrocephalus. The primary purpose was to review the demographics. The secondary objectives were to review the clinical presentation, operative intervention executed, and outcome of the cases published on trans-vaginal extrusion of the distal VPS catheter. The literature and case reports were retrieved from 1973 to September 30, 2021. This literature review included (n=19) cases of the above-mentioned VPS complication. The mean age of 15 children at the time of diagnosis of the complication was 18.13 months and ranged from 2 to 72 months. For the entire case, the interval from the initial VPS insertion/VPS revision to the clinical diagnosis of complication ranged from 1 to 36 months, with a mean of 8.16 months. In three-fourth of the cases, it was detected within 6-months of the VPS implantation. Extrusion of the distal VPS catheter through the vagina was the chief complaint. Surgical procedures were performed in the following order of frequency (A) removal of the entire VPS catheter (n=14), and (B) removal of the distal/peritoneal VPS catheter (n=3). During the postoperative period, one of the children died. Extrusion of the distal VPS catheter through the vaginal orifice is a rare complication of VPS insertion. It occurred across all the age groups but was more common during early childhood. Three-fourth of them were treated by removal of the entire VPS catheter. For VPS revision, delayed re-VPS insertion was the preferred option.

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Section: Discussionmentioning

confidence: 99%

Management of trans-vaginal extrusion of the distal ventriculoperitoneal shunt catheter: a systematic literature review from 1973 to 2021

Ghritlaharey

2021

Int J Res Med Sci

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“…All the n = 46 manuscripts included for systematic review are full-text articles[ 17 - 62 ]. Thirty-five manuscripts described/detailed the isolated case[ 17 , 19 , 23 - 30 , 32 , 33 , 37 - 43 , 45 , 46 , 48 - 54 , 56 - 62 ]. Two of the manuscripts included in the review are original articles[ 35 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Migration of the distal ventriculoperitoneal shunt catheter into the stomach with or without trans-oral extrusion: A systematic literature review and meta-analysis

Ghritlaharey

2023

World J Clin Pediatr

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BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt (VPS) catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter insertion. AIM To identify the demographics, clinical presentation, clinical findings, and results of surgical therapy offered for the treatment of intra-gastric migration of the distal VPS catheter, clinically presented with or without trans-oral extrusion. METHODS An online search was performed for the extraction/retrieval of the published/ available literature pertaining to the above-mentioned VPS complication. Manuscripts were searched from PubMed, PMC (PubMed Central), ResearchGate, and Google Scholar databases using various terminology relating to the VPS complications. The first case of migration of a VPS catheter into the stomach was reported in the year 1980, and the data were retrieved from 1980 to December 2022. Cases were categorized into two groups; Group A: Cases who had migration of the distal VPS catheter into the stomach and clinically presented with trans-oral extrusion of the same, and Group B: Cases who had migration of the distal VPS catheter into the stomach, but presented without trans-oral extrusion. RESULTS A total of n = 46 cases (n = 27; 58.69% male, and n = 19; 41.3% females) were recruited for the systematic review. Group A included n = 32, and Group B n = 14 cases. Congenital hydrocephalus was the indication for the primary VPS insertion for approximately half of the (n = 22) cases. Approximately sixty percent (n = 27) of them were children ≤ 5 years of age at the time of the diagnosis of the complication mentioned above. In seventy-two percent (n = 33) cases, this complication was detected within 24 mo after the VPS insertion/last shunt revision. Clinical diagnosis was evident for the entire group A cases. Various diagnostic modalities were used to confirm the diagnosis for Group B cases. Various surgical procedures were offered for the management of the complication in n = 43 cases of both Groups. In two instances, intra-gastric migration of the distal VPS catheter was detected during the autopsy. This review documented four deaths. CONCLUSION Intra-gastric migration of the peritoneal end of a VPS catheter is one of the rare complications of VPS catheter implantation done for the treatment of hydrocephalus across all age groups. It was more frequently reported in children, although also reported in adults and older people. A very high degree of clinical suspicion is required for the diagnosis of a case of an intra-gastric migration of the distal VPS catheter clinically presenting without trans-oral extrusion.

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“…Perforation of the hollow viscera like stomach, small intestine, colon, urinary bladder, and uterus by the distal/peritoneal catheter of the VPS system is a known complication of the VPS placement, and all have been reported in the literature. 12,[15][16][17][18][19] Extrusion of the distal VPS catheter via rectum/anal canal is reported in 0.1% to 2.5% of the cases. 7,[9][10][11][12]20 In the present study, n=25 of 994 (2.51%) children presented with the trans-anal extrusion of the distal VPS catheter during the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Management of trans-anal extrusion of distal ventriculoperitoneal shunt catheter in children

Ghritlaharey

2022

Int J Res Med Sci

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Background: The objectives of this study were to review the demographics, clinical characteristics, surgical procedures executed, and the outcome of children operated upon for trans-anal extrusion of the distal VPS (ventriculoperitoneal shunt) catheter.Methods: Case records of children under 12-years, operated upon for the trans-anal extrusion of the distal VPS catheter, were reviewed in detail.Results: This study comprised of, n=25 children and included, n=14 boys and, n=11 girls. The interval from the primary VPS insertion/VPS revision to the diagnosis of trans-anal extrusion of the distal VPS catheter ranged from 2 to 49-months, with a mean of 10.04 (11.58 SD/ months. Clinically, all children presented with trans-anal extrusion of the distal VPS catheter. None of them had clinical features of peritonitis, intestinal obstruction, or meningitis. Operative procedures performed in the following order of frequency; (a) removal and immediate revision of the peritoneal/distal VPS catheter n=15 (60%), (b) removal of entire VPS catheter and delayed re-VPS insertion n=4 (16%), (c) removal of peritoneal/distal VPS catheter, external ventricular drainage (EVD) followed by delayed re-VPS insertion n=3 (12%), (d) removal of entire VPS catheter and immediate re-VPS insertion n=1 (4%) and (e) removal of entire VPS catheter alone n=2 (8%). Conclusions: Trans-anal extrusion of the distal VPS catheter is well-known, but rare complication of the VPS insertion done in children. In sixty percent of children, removal and immediate revision of the peritoneal/distal VPS catheters were done safely by mini-laparotomy. During the management, formal abdominal explorations were neither executed nor required in any case.

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Transoral Protrusion of a Ventriculoperitoneal Catheter Caused by Jejunal Perforation in an Adult: Rare Case Report and Review of the Literature

Cited by 9 publications

References 29 publications

Management of trans-vaginal extrusion of the distal ventriculoperitoneal shunt catheter: a systematic literature review from 1973 to 2021

Management of trans-vaginal extrusion of the distal ventriculoperitoneal shunt catheter: a systematic literature review from 1973 to 2021

Migration of the distal ventriculoperitoneal shunt catheter into the stomach with or without trans-oral extrusion: A systematic literature review and meta-analysis

Management of trans-anal extrusion of distal ventriculoperitoneal shunt catheter in children

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