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Background <p>Ventriculoperitoneal (VP) shunt is considered as primary treatment for hydrocephalus, but is associated with many complications with bowel perforation being one of them. Although trans-anal extrusion of the distal catheter is exceedingly rare ; simultaneous bilateral shunt migration has scarcely been reported.</p> Case presentation <p>We report a 14-month male child with post-ventriculitis multiloculated hydrocephalus who underwent bilateral Ventriculo Peritoneal(VP) shunt placement after failed endoscopic third ventriculostomy. Six months later, he presented with spontaneous extrusion of the distal ends of both shunts through the anal canal without signs of peritonitis or meningitis. Imaging confirmed colonic perforation at the splenic flexure by both catheters. The shunts were removed, and bilateral Ommaya reservoirs were placed. Despite initial clinical stability and sterile cerebrospinal fluid cultures, the child’s course got complicated by fungal ventriculitis and seizures and he succumbed to his illness.</p> Conclusion <p>This case highlights a rare and fatal complication of ventriculo peritoneal shunting, emphasizing the need for early recognition, meticulous management, and vigilant postoperative surveillance in high-risk pediatric patients.</p>

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Simultaneous spontaneous transanal extrusion of bilateral ventriculoperitoneal shunts in a child with multiloculated hydrocephalus: a rare case report

  • 期刊论文

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  • 发表日期：

    2026年7月29日

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  • Zoya Sehar,
  • Aamir H. Hela,
  • Junaid R. Dar

摘要

Background

Ventriculoperitoneal (VP) shunt is considered as primary treatment for hydrocephalus, but is associated with many complications with bowel perforation being one of them. Although trans-anal extrusion of the distal catheter is exceedingly rare ; simultaneous bilateral shunt migration has scarcely been reported.

Case presentation

We report a 14-month male child with post-ventriculitis multiloculated hydrocephalus who underwent bilateral Ventriculo Peritoneal(VP) shunt placement after failed endoscopic third ventriculostomy. Six months later, he presented with spontaneous extrusion of the distal ends of both shunts through the anal canal without signs of peritonitis or meningitis. Imaging confirmed colonic perforation at the splenic flexure by both catheters. The shunts were removed, and bilateral Ommaya reservoirs were placed. Despite initial clinical stability and sterile cerebrospinal fluid cultures, the child’s course got complicated by fungal ventriculitis and seizures and he succumbed to his illness.

Conclusion

This case highlights a rare and fatal complication of ventriculo peritoneal shunting, emphasizing the need for early recognition, meticulous management, and vigilant postoperative surveillance in high-risk pediatric patients.