Transanal Migration of a Ventriculoperitoneal Shunt in Pediatric Patient: A Late Complication after 2 Years

A

BSTRACT

Ventriculoperitoneal (VP) shunting is a standard treatment for hydrocephalus in children, but it carries a risk of rare complications, including gastrointestinal perforation and distal catheter migration. Among these, transanal extrusion of the shunt catheter is extremely uncommon and potentially serious, requiring timely diagnosis and coordinated management. We report the case of a 12-year-old boy who presented with a 3-month history of shunt catheter extrusion per anus during defecation, without associated abdominal pain or neurological symptoms. The patient also developed intermittent fever for 9 days prior to admission. He had a history of posterior fossa tumor resection and VP shunt placement 2 years earlier. Physical examination revealed a stable general condition with anal extrusion of the distal shunt tubing. A prior computed tomography scan showed no hydrocephalus, and plain abdominal X-ray views revealed no signs of acute abdomen. The patient underwent surgical removal of the shunt and placement of an external ventricular drainage. On the 5 ^th day of hospitalization, a dependent test was performed, and there were no signs of increased intracranial pressure. The external ventricle drainage subsequently removed, and the patient was discharged in good condition. Transanal migration of a VP shunt is a rare but significant complication that may occur years after shunt placement. Despite its low incidence, the condition can lead to serious infectious and surgical outcomes if not promptly recognized and managed.