{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:17:01Z","timestamp":1788308221920,"version":"build-2803163510"},"reference-count":9,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"10","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,9,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Transanal protrusion of a ventriculoperitoneal (VP) shunt catheter is an uncommon manifestation of bowel perforation. Most reports favor shunt removal or externalization because retrograde contamination may cause ventriculitis, meningitis, peritonitis, or sepsis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 69-year-old man with posttuberculous hydrocephalus and bilateral VP shunts presented 20 days after trocar-assisted left distal catheter reinsertion with the catheter protruding 2 cm beyond the anus. He was afebrile and without peritonitis or meningismus. Recent CSF testing showed clear, colorless CSF with minimal pleocytosis, negative acid-fast bacilli smear, and no fungal growth. CT showed the left distal catheter in the rectal lumen without free air or fluid. Laparoscopy showed no enteric fluid or pus; the right shunt catheter remained functional, and the left catheter penetrated the sigmoid colon. The intraluminal segment was removed transanally, the sigmoid defect was closed laparoscopically with 3-0 polydioxanone, and the proximal shunt system was preserved. Ceftriaxone was administered for 14 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>In highly selected shunt-dependent patients without peritonitis, abscess, gross contamination, or CNS infection, laparoscopy can define contamination, permit bowel repair, and support cautious shunt preservation with close follow-up.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26487\">https:\/\/thejns.org\/doi\/10.3171\/CASE26487<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26487","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:48Z","timestamp":1788307248000},"source":"Crossref","is-referenced-by-count":0,"title":["Shunt-preserving laparoscopic management of transanal ventriculoperitoneal shunt catheter protrusion without peritonitis: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0454-6836","authenticated-orcid":true,"given":"Nguyen Van","family":"Tuan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, People\u2019s Hospital 115, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le Nguyen","family":"Duy Khuong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, People\u2019s Hospital 115, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"bib1","series-title":"Yale J Biol Med","first-page":"313","article-title":"A review of cerebral shunts, current technologies, and future endeavors","volume":"91","author":"Soler","year":"2018","unstructured":"Soler GJBao MJaiswal DA review of cerebral shunts, current technologies, and future endeavors. Yale J Biol Med. 2018;91(3):313-321."},{"key":"bib2","series-title":"World Neurosurg","first-page":"654","article-title":"The rate of complications after ventriculoperitoneal shunt surgery","volume":"98","author":"Merkler","year":"2017","unstructured":"Merkler AECh'ang JParker WEMurthy SBKamel H.The rate of complications after ventriculoperitoneal shunt surgery. World Neurosurg. 2017;98:654-658. doi:10.1016\/j.wneu.2016.10.136"},{"issue":"2","key":"bib3","series-title":"World Neurosurg","first-page":"404","article-title":"Long-term outcomes of ventriculoperitoneal shunt surgery in patients with hydrocephalus","volume":"81","author":"Reddy","year":"2014","unstructured":"Reddy GKBollam PCaldito G.Long-term outcomes of ventriculoperitoneal shunt surgery in patients with hydrocephalus. World Neurosurg. 2014;81(2):404-410. doi:10.1016\/j.wneu.2013.01.096"},{"issue":"6","key":"bib4","series-title":"Pediatr Surg Int","first-page":"575","article-title":"Trans-anal protrusion of ventriculo-peritoneal shunt catheter with silent bowel perforation: report of ten cases in children","volume":"23","author":"Ghritlaharey","year":"2007","unstructured":"Ghritlaharey RKBudhwani KSShrivastava DKTrans-anal protrusion of ventriculo-peritoneal shunt catheter with silent bowel perforation: report of ten cases in children. Pediatr Surg Int. 2007;23(6):575-580. doi:10.1007\/s00383-007-1916-8"},{"issue":"11","key":"bib5","series-title":"J Clin Diagn Res","first-page":"PE01","article-title":"Review of the management of peroral extrusion of ventriculoperitoneal shunt catheter","volume":"10","author":"Ghritlaharey","year":"2016","unstructured":"Ghritlaharey RK.Review of the management of peroral extrusion of ventriculoperitoneal shunt catheter. J Clin Diagn Res. 2016;10(11):PE01-PE06. doi:10.7860\/JCDR\/2016\/23372.8920"},{"issue":"5","key":"bib6","series-title":"Surg Neurol","first-page":"388","article-title":"Spontaneous bowel perforation after ventriculoperitoneal shunt surgery: case report and a review of 45 cases","volume":"54","author":"Sathyanarayana","year":"2000","unstructured":"Sathyanarayana SWylen ELBaskaya MKNanda A.Spontaneous bowel perforation after ventriculoperitoneal shunt surgery: case report and a review of 45 cases. Surg Neurol. 2000;54(5):388-396. doi:10.1016\/S0090-3019(00)00334-7"},{"issue":"5","key":"bib7","series-title":"J Surg Case Rep","first-page":"rjae306","article-title":"Anal extrusion of a ventriculoperitoneal shunt in a 1-month-old patient: a case report","volume":"2024","author":"Kencana","year":"2024","unstructured":"Kencana IGKASMaliawan SLauren CAdityawarma AANAHJapardi D.Anal extrusion of a ventriculoperitoneal shunt in a 1-month-old patient: a case report. J Surg Case Rep. 2024;2024(5):rjae306. doi:10.1093\/jscr\/rjae306"},{"issue":"3","key":"bib8","series-title":"Neurol India","first-page":"334","article-title":"Peroral extrusion of ventriculoperitoneal shunt: case report and review of literature","volume":"57","author":"Sridhar","year":"2009","unstructured":"Sridhar KKarmarkar V.Peroral extrusion of ventriculoperitoneal shunt: case report and review of literature. Neurol India. 2009;57(3):334-336. doi:10.4103\/0028-3886.53283"},{"issue":"1","key":"bib9","series-title":"Neurol India","first-page":"85","article-title":"Shunt migration in \u00adventriculoperitoneal shunting: a comprehensive review of literature","volume":"67","author":"Harischandra","year":"2019","unstructured":"Harischandra LSSharma AChatterjee S.Shunt migration in \u00adventriculoperitoneal shunting: a comprehensive review of literature. Neurol India. 2019;67(1):85-99. doi:10.4103\/0028-3886.253968"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/10\/article-CASE26487.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/10\/article-CASE26487.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/10\/article-CASE26487.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:49Z","timestamp":1788307249000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/10\/article-CASE26487.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":9,"journal-issue":{"issue":"10"},"URL":"https:\/\/doi.org\/10.3171\/case26487","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]}}}