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We present a case of transanal protrusion of the shunt catheter in an otherwise asymptomatic patient, with only transient signs of shunt failure some 2\u2005months prior to presentation, and discuss treatment options to rationalise our decision to treat with laparotomy and preservation of the shunt.<\/jats:p>","DOI":"10.1136\/bcr-2014-204842","type":"journal-article","created":{"date-parts":[[2014,5,14]],"date-time":"2014-05-14T10:49:45Z","timestamp":1400064585000},"page":"bcr2014204842","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Transanal protrusion of ventriculoperitoneal shunt reflecting asymptomatic perforation of the large bowel"],"prefix":"10.1136","volume":"2014","author":[{"given":"Nicholas Russell","family":"Plummer","sequence":"first","affiliation":[{"name":"Department of Upper GI Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Tokala","sequence":"additional","affiliation":[{"name":"Department of Radiology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravindra S","family":"Date","sequence":"additional","affiliation":[{"name":"Department of Upper GI Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK"},{"name":"Department of Medicine, University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,5,14]]},"reference":[{"key":"2025082803132260000_2014.may14_1.bcr2014204842.1","doi-asserted-by":"publisher","DOI":"10.1586\/eri.11.137"},{"key":"2025082803132260000_2014.may14_1.bcr2014204842.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-006-0308-8"},{"key":"2025082803132260000_2014.may14_1.bcr2014204842.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-3019(00)00334-7"},{"key":"2025082803132260000_2014.may14_1.bcr2014204842.4","doi-asserted-by":"publisher","DOI":"10.1159\/000334277"},{"issue":"(1 Suppl)","key":"2025082803132260000_2014.may14_1.bcr2014204842.5","first-page":"ONS76","article-title":"Bowel perforation caused by peritoneal shunt catheters: diagnosis and treatment","volume":"58","author":"Vinchon","year":"2006","journal-title":"Neurosurgery"},{"key":"2025082803132260000_2014.may14_1.bcr2014204842.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-007-1916-8"},{"key":"2025082803132260000_2014.may14_1.bcr2014204842.7","doi-asserted-by":"crossref","first-page":"149","DOI":"10.4103\/1817-1745.92847","article-title":"Transoral extrusion of the ventriculoperitoneal shunt: a case report and review of literature","volume":"6","author":"Agarwal","year":"2011","journal-title":"J Pediatr Neurosci"},{"key":"2025082803132260000_2014.may14_1.bcr2014204842.8","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2003.324"},{"key":"2025082803132260000_2014.may14_1.bcr2014204842.9","doi-asserted-by":"publisher","DOI":"10.1177\/147323000703500624"},{"key":"2025082803132260000_2014.may14_1.bcr2014204842.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-3019(97)00014-1"},{"key":"2025082803132260000_2014.may14_1.bcr2014204842.11","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.48.526"},{"key":"2025082803132260000_2014.may14_1.bcr2014204842.12","doi-asserted-by":"publisher","DOI":"10.1016\/0090-3019(86)90289-2"},{"key":"2025082803132260000_2014.may14_1.bcr2014204842.13","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e318217df9a"},{"key":"2025082803132260000_2014.may14_1.bcr2014204842.14","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-009-1013-5"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-204842","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:13:29Z","timestamp":1756376009000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-204842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,14]]},"references-count":14,"alternative-id":["10.1136\/bcr-2014-204842"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-204842","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2014,5,14]]}}}