Management of trans-anal extrusion of distal ventriculoperitoneal shunt catheter in children

Authors

  • Rajendra K. Ghritlaharey Department of Pediatric Surgery, Gandhi Medical College and Associated, Kamla Nehru and Hamidia Hospitals, Bhopal, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20220509

Keywords:

Children, Complication, Extrusion, Hydrocephalus, Infants, Shunt revision, Ventriculoperitoneal shunt

Abstract

Background: The objectives of this study were to review the demographics, clinical characteristics, surgical procedures executed, and the outcome of children operated upon for trans-anal extrusion of the distal VPS (ventriculoperitoneal shunt) catheter.

Methods: Case records of children under 12-years, operated upon for the trans-anal extrusion of the distal VPS catheter, were reviewed in detail.

Results: This study comprised of, n=25 children and included, n=14 boys and, n=11 girls. The interval from the primary VPS insertion/VPS revision to the diagnosis of trans-anal extrusion of the distal VPS catheter ranged from 2 to 49-months, with a mean of 10.04 (11.58 SD/ months. Clinically, all children presented with trans-anal extrusion of the distal VPS catheter. None of them had clinical features of peritonitis, intestinal obstruction, or meningitis. Operative procedures performed in the following order of frequency; (a) removal and immediate revision of the peritoneal/distal VPS catheter n=15 (60%), (b) removal of entire VPS catheter and delayed re-VPS insertion n=4 (16%), (c) removal of peritoneal/distal VPS catheter, external ventricular drainage (EVD) followed by delayed re-VPS insertion n=3 (12%), (d) removal of entire VPS catheter and immediate re-VPS insertion n=1 (4%) and (e) removal of entire VPS catheter alone n=2 (8%).                          

Conclusions: Trans-anal extrusion of the distal VPS catheter is well-known, but rare complication of the VPS insertion done in children. In sixty percent of children, removal and immediate revision of the peritoneal/distal VPS catheters were done safely by mini-laparotomy. During the management, formal abdominal explorations were neither executed nor required in any case.

Author Biography

Rajendra K. Ghritlaharey, Department of Pediatric Surgery, Gandhi Medical College and Associated, Kamla Nehru and Hamidia Hospitals, Bhopal, Madhya Pradesh, India

Prof and Head, Department  of Pediatric  Surgery,                  Gandhi  Medical  College, Bhopal 462001, India

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Published

2022-02-25

How to Cite

Ghritlaharey, R. K. (2022). Management of trans-anal extrusion of distal ventriculoperitoneal shunt catheter in children. International Journal of Research in Medical Sciences, 10(3), 628–638. https://doi.org/10.18203/2320-6012.ijrms20220509

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Original Research Articles