Authors
Biniam Melese Bekele, Dimitri Tkatschenko, Thomas Machemehl, Yu-Mi Ryang
Published in
International journal of surgery case reports. Volume 138. Issue 11. Pages 4788-4793. Epub Oct 26, 2026.
Abstract
Bowel perforation by a ventriculoperitoneal (VP) shunt catheter is a rare but serious complication that may present insidiously without peritoneal signs and can result in polymicrobial cerebrospinal fluid (CSF) infection.
A 48-year-old female patient with a VP shunt implanted in 2011 presented with headache, nausea, and vomiting consistent with shunt dysfunction. She was afebrile with no signs of peritonitis or systemic infection. CSF analysis showed polymicrobial growth, including Escherichia coli and Streptococcus mitis, suggesting enteric communication. Abdominal computed tomography showed intraluminal positioning of the distal catheter in the transverse colon. Laparoscopy confirmed chronic transcolonic migration without peritonitis. The shunt was externalized, weaned and finally removed. Targeted antibiotics were initiated. After initial stability, recurrent hydrocephalus required delayed shunt reimplantation. The patient recovered without neurological deficit or infection.
VP shunt-associated bowel perforation may present as an isolated shunt dysfunction. The presence of enteric organisms in CSF is a key diagnostic clue. Early multidisciplinary management is critical for favorable outcomes.
PMID:
43006094
Bibliographic data and abstract were imported from PubMed on 10 Nov 2026.
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