{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T18:08:41Z","timestamp":1793729321815,"version":"4.6.1"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T00:00:00Z","timestamp":1583798400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T00:00:00Z","timestamp":1583798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Bowel perforation caused by the ventriculo-peritoneal shunt is a rare occurrence with an estimated incidence rate of 0.1% to 1.0% among all cases of VP shunt displacement. This is an unusual report of spontaneous trans-anal extrusion of caudally migrated ventriculo-peritoneal shunt tip in a child. Literature was reviewed to find out therapeutic strategies.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>An asymptomatic 8\u2009months old boy presented with spontaneous trans-anal extrusion of caudally migrated left-sided Chhabra type of ventriculo-peritoneal (VP) shunt for last 1\u2009day, following surgery for hydrocephalus initially done 3\u2009months ago. He had no features of peritonitis or encephalitis. Digital X-ray of the whole abdomen in postero-anterior view in erect posture was only evident of the expulsion of radio-opaque distal catheter tip through the anus into the exterior. Noncontrast-enhanced computed tomography scan (NCCT) of brain showed proximal catheter in the lateral ventricle of the brain. Under sedation, the distal part of the VP shunt catheter was resected out, aseptically, over the abdomen and pulled out gently through the anus. The proximal catheter part along with the reservoir was removed through a separate incision in the neck and sent for bacteriological study, which came out later to be negative. Postoperatively, the child was put on a prophylactic antibiotic and 3\u2009weeks later another VP shunt was placed in the contralateral side.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Spontaneous trans-anal extrusion of VP shunt tip is a surgical emergency. The whole catheter must be removed aseptically in such a way that both contamination of the cerebral cavity and spillage into the peritoneum can be avoided. Awareness of this unusual complication among surgeons is needed for early recognition, management, and timely intervention to minimize morbidity.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40792-020-00813-0","type":"journal-article","created":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T09:03:33Z","timestamp":1583831013000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Spontaneous trans-anal extrusion of caudally migrated ventriculo-peritoneal shunt tip in a child: a case report"],"prefix":"10.1186","volume":"6","author":[{"given":"Sabyasachi","family":"Bakshi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,10]]},"reference":[{"key":"813_CR1","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1148\/radiology.146.2.6849079","volume":"146","author":"F Agha","year":"1983","unstructured":"Agha F, Amendola MA. Unusual abdominal complications of ventriculoperitoneal shunts. Radiology. 1983;146:323\u20136.","journal-title":"Radiology."},{"key":"813_CR2","doi-asserted-by":"publisher","first-page":"525","DOI":"10.3171\/jns.1967.27.6.0525","volume":"27","author":"RH Ames","year":"1967","unstructured":"Ames RH. Ventriculoperitoneal shunt: the management of hydrocephalus. J Neurosurg. 1967;27:525\u20139.","journal-title":"J Neurosurg"},{"key":"813_CR3","doi-asserted-by":"publisher","first-page":"758","DOI":"10.3171\/jns.1973.38.6.0758","volume":"38","author":"A Adeloye","year":"1973","unstructured":"Adeloye A. Spontaneous extrusion of the abdominal tube through the umbilicus complicating peritoneal shunt for hydrocephalus. J Neurosurg. 1973;38:758\u201360.","journal-title":"J Neurosurg"},{"key":"813_CR4","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1007\/s003830100608","volume":"18","author":"AA Wani","year":"2002","unstructured":"Wani AA, Ramzan A, Wani MA. 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Unusual complication of ventriculoperitoneal shunt: anal extrusion. MJAFI. 2007;63:82\u20134.","journal-title":"MJAFI"},{"key":"813_CR8","first-page":"86","volume":"35","author":"S Panagea","year":"1997","unstructured":"Panagea S, Cartmill TD, Panigrahi H. Intracerebral sepsis due to intestinal perforation by ventriculo-peritoneal shunts: two cases. J Inf Secur. 1997;35:86\u20138.","journal-title":"J Inf Secur"},{"key":"813_CR9","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1016\/S0090-3019(00)00334-7","volume":"54","author":"S Sathyanarayana","year":"2000","unstructured":"Sathyanarayana S, Wylen EL, Baskaya MK, Nanda A. Spontaneous bowel perforation after ventriculoperitoneal shunt surgery: case report and a review of 45 cases. Surg Neurol. 2000;54:388\u201396.","journal-title":"Surg Neurol"},{"key":"813_CR10","doi-asserted-by":"publisher","first-page":"31","DOI":"10.4103\/0971-9261.74521","volume":"16","author":"A Hai","year":"2011","unstructured":"Hai A, Rab AZ, Ghani I, Huda MF, Quadir AQ. Perforation into gut by ventriculoperitoneal shunts: a report of two cases and review of the literature. J Indian Assoc Pediatr Surg. 2011;16:31\u20133.","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"813_CR11","first-page":"29","volume":"22","author":"A Sharma","year":"2003","unstructured":"Sharma A, Pandey AK, Radhakrishnan M, Kumbhani D, Das HS, Desai N. Endoscopic management of anal protrusion of ventriculoperitoneal shunt. Indian J Gastroenterol. 2003;22:29\u201330.","journal-title":"Indian J Gastroenterol"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-020-00813-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s40792-020-00813-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-020-00813-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T00:09:45Z","timestamp":1615334985000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-020-00813-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,10]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["813"],"URL":"https:\/\/doi.org\/10.1186\/s40792-020-00813-0","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,10]]},"assertion":[{"value":"27 January 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 February 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 March 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent to publish was obtained from the parent of the subject, for the publication of all clinical details and images and the consent form is available for review by the editor of the journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The author declares that he has no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"50"}}