Asymptomatic perforation of large bowel and urinary bladder as a complication of ventriculoperitoneal shunt: Report of two cases
2012
Introduction. Insertion of a ventriculoperitoneal (VP) shunt, the method of
choice in the treatment of hydrocephalus, is often followed by various
mechanical and/or infective complications. We present two children with
asymptomatic perforation of the large bowel and urinary bladder, relatively
rare and potentially severe complications of this surgical procedure.
Outline of Cases. In both patients a VP shunt was implanted in the first
month after birth; in a boy due to congenital hydrocephalus and in a girl
due to the consequences of intracranial haemorrhage. Immediately after
surgery, as well as during the further course, in both children growth and
development were optimal and without any signs of infection or VP shunt
malfunction. In the boy at age 6 months and in the girl at age 4 years,
without any signs of complications, mothers noted the prominence of the VP
shunt tip from the anus in the first case and from the urethral orifice in
the second one. The VP shunts were immediately changed, so that both
complications were resolved without any consequences. Conclusion. Insertion
of a VP shunt represents the most frequent method of choice of the surgical
treat- ment of hydrocephalus, but also potentially a highly risky procedure
followed by various complications about which parents should be informed
when patients are children. Owing to adequate approach in the follow-up of
children with implanted VP shunt, large bowel and urinary bladder
perforation, examples of severe and potentially fatal complications of this
surgical intervention, could be disclosed on time and adequately resolved.
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