71-year-old male with normal pressure hydrocephalus status post ventriculoperitoneal shunt (VPS) placement presented for an outpatient screening colonoscopy. He had multiple ED visits and hospitalizations for recurrent fever and chills of unclear etiology. He had negative blood, fungal and cerebrospinal fluid (CSF) cultures. No shunt malfunction was noted on X-ray series. Abdominal computed tomography (CT) revealed nonspecific descending colonic wall thickening. He was given multiple courses of empiric antibiotics over a few months. The colonoscopy incidentally revealed his VPS perforating the transverse colon (Fig. 1), with the distal end in the proximal descending colon (Fig. 2).
Fig. 1.
Endoscopic image of a ventriculoperitoneal shunt perforating the transverse colon
Fig. 2
Endoscopic imagine showing the distal end of a ventriculoperitoneal shunt in the proximal descending colon
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