Skip to main content
Top
Published in: Child's Nervous System 4/2013

01-04-2013 | Case Report

Urinary bladder perforation, intra-corporeal knotting, and per-urethral extrusion of ventriculoperitoneal shunt in a single patient: case report and review of literature

Authors: Rashim Kataria, Virendra D Sinha, Sanjeev Chopra, Ashok Gupta, Nachiket Vyas

Published in: Child's Nervous System | Issue 4/2013

Login to get access

Abstract

Background

Ventriculoperitoneal shunt (VPS) surgery is the most common procedure performed for the treatment of hydrocephalus. Erosive bladder perforation by a peritoneal catheter is an extremely rare complication of VPS. Only ten cases involving the normal (non-augmented) urinary bladder have been reported so far.

Case

We report a case of erosive bladder perforation, intra-corporeal knot formation, and perurethral extrusion of the distal end of VPS. This is the second only case report so far in the world literature showing triad of uncommon VPS complications in a single patient.

Conclusion

Prompt management could avoid further complications. Patient’s parents should be aware about this rare complication, so that they can seek timely medical help.
Literature
1.
go back to reference Barker GM, Läckgren G, Stenberg A, Arnell K (2006) Distal shunt obstruction in children with myelomeningocele after bladder perforation. J Urol 176:1726–8PubMedCrossRef Barker GM, Läckgren G, Stenberg A, Arnell K (2006) Distal shunt obstruction in children with myelomeningocele after bladder perforation. J Urol 176:1726–8PubMedCrossRef
2.
go back to reference Binning MJ, Ragel BT, Walker ML, Kestle JRW (2006) Retained peritoneal shunt tubing causing hematuria: case illustration. J Neurosurg 104:434PubMed Binning MJ, Ragel BT, Walker ML, Kestle JRW (2006) Retained peritoneal shunt tubing causing hematuria: case illustration. J Neurosurg 104:434PubMed
3.
go back to reference Boch AL, Hermelin E, Sainte-Rose C, Sgouros S (1998) Mechanical dysfunction of ventriculoperitoneal shunts caused by calcification of the silicone rubber catheter. J Neurosurg 88:975–82PubMedCrossRef Boch AL, Hermelin E, Sainte-Rose C, Sgouros S (1998) Mechanical dysfunction of ventriculoperitoneal shunts caused by calcification of the silicone rubber catheter. J Neurosurg 88:975–82PubMedCrossRef
4.
go back to reference Chen TH, Lin MS, Kung WM, Hung KS, Chiang YH, Chen CH (2011) Combined ventriculoperitoneal shunt blockage, viscus perforation with migration into urethra, presenting with repeated UTI. Ann R Coll Surg Engl 93:151–153CrossRef Chen TH, Lin MS, Kung WM, Hung KS, Chiang YH, Chen CH (2011) Combined ventriculoperitoneal shunt blockage, viscus perforation with migration into urethra, presenting with repeated UTI. Ann R Coll Surg Engl 93:151–153CrossRef
5.
go back to reference Couldwell WT, LeMay DR, McComb JG (1996) Experience with use of extended length peritoneal shunt catheters. J Neurosurg 85:425–7PubMedCrossRef Couldwell WT, LeMay DR, McComb JG (1996) Experience with use of extended length peritoneal shunt catheters. J Neurosurg 85:425–7PubMedCrossRef
6.
go back to reference de Aguiar GB, Mizrahi C, Aquino JH, Tavares CM, Telles C, Nigri F, Acioly MA (2011) Urethral extrusion of a peritoneal catheter in a patient with a neobladder: a rare complication of shunt insertion. Neuropediatrics 42:124–127PubMedCrossRef de Aguiar GB, Mizrahi C, Aquino JH, Tavares CM, Telles C, Nigri F, Acioly MA (2011) Urethral extrusion of a peritoneal catheter in a patient with a neobladder: a rare complication of shunt insertion. Neuropediatrics 42:124–127PubMedCrossRef
7.
go back to reference de Aquino HB, Carelli EF, Borges Neto AG, Pereira CU et al (2006) Nonfunctional abdominal complications of the distal catheter on the treatment of hydrocephalus: an inflammatory hypothesis? Experience with six cases. Childs Nerv Syst 22:1225–1230PubMedCrossRef de Aquino HB, Carelli EF, Borges Neto AG, Pereira CU et al (2006) Nonfunctional abdominal complications of the distal catheter on the treatment of hydrocephalus: an inflammatory hypothesis? Experience with six cases. Childs Nerv Syst 22:1225–1230PubMedCrossRef
8.
go back to reference De Jong L, Van Der Aa F, De Ridder D, Van Calenbergh F (2011) Extrusion of a ventriculoperitoneal shunt catheter through an appendicovesicostomy. Br J Neurosurg 25:115–6PubMedCrossRef De Jong L, Van Der Aa F, De Ridder D, Van Calenbergh F (2011) Extrusion of a ventriculoperitoneal shunt catheter through an appendicovesicostomy. Br J Neurosurg 25:115–6PubMedCrossRef
9.
go back to reference Dominguez CJ, Tyagi A, Hall G, Timothy J, Chumas PD (2000) Sub-galeal coiling of the proximal and distal components of a ventriculo-peritoneal shunt. An unusual complication and proposed mechanism. Childs Nerv Syst 16:493–5PubMedCrossRef Dominguez CJ, Tyagi A, Hall G, Timothy J, Chumas PD (2000) Sub-galeal coiling of the proximal and distal components of a ventriculo-peritoneal shunt. An unusual complication and proposed mechanism. Childs Nerv Syst 16:493–5PubMedCrossRef
10.
go back to reference Eichel L, Allende R, Mevorach RA, Hulbert WC, Rabinowitz R (2002) Bladder calculus formation and urinary retention secondary to perforation of a normal bladder by a ventriculoperitoneal shunt. Urology 60:344PubMedCrossRef Eichel L, Allende R, Mevorach RA, Hulbert WC, Rabinowitz R (2002) Bladder calculus formation and urinary retention secondary to perforation of a normal bladder by a ventriculoperitoneal shunt. Urology 60:344PubMedCrossRef
11.
go back to reference Grosfeld JL, Cooney DR, Smith J, Campbell RL (1974) Intra-abdominal complications following ventriculoperitoneal shunt procedures. Pediatrics 54:791–796PubMed Grosfeld JL, Cooney DR, Smith J, Campbell RL (1974) Intra-abdominal complications following ventriculoperitoneal shunt procedures. Pediatrics 54:791–796PubMed
12.
go back to reference Mevorach RA, Hulbert WC, Merguerian PA, Rabinowitz R (1992) Perforation and intravesical erosion of a ventriculoperitoneal shunt in a child with an augmentation cystoplasty. J Urol 147:433–434PubMed Mevorach RA, Hulbert WC, Merguerian PA, Rabinowitz R (1992) Perforation and intravesical erosion of a ventriculoperitoneal shunt in a child with an augmentation cystoplasty. J Urol 147:433–434PubMed
13.
go back to reference Mihajlović M, Tasić G, Raičević M, Mrdak M, Petrović B, Radlović V (2012) Asymptomatic perforation of large bowel and urinary bladder as a complication of ventriculoperitoneal shunt: report of two cases. Srp Arh Celok Lek 140:211–215PubMedCrossRef Mihajlović M, Tasić G, Raičević M, Mrdak M, Petrović B, Radlović V (2012) Asymptomatic perforation of large bowel and urinary bladder as a complication of ventriculoperitoneal shunt: report of two cases. Srp Arh Celok Lek 140:211–215PubMedCrossRef
14.
go back to reference Murthy KVR, Reddy SJ, Prasad DVSRK (2009) Perforation of the distal end of the ventriculoperitoneal shunt into the bladder with calculus formation. Pediatric Neurosurgery 45:53–55CrossRef Murthy KVR, Reddy SJ, Prasad DVSRK (2009) Perforation of the distal end of the ventriculoperitoneal shunt into the bladder with calculus formation. Pediatric Neurosurgery 45:53–55CrossRef
15.
go back to reference Pohlman GD, Wilcox DT, Hankinson TC (2011) Erosive bladder perforation as a complication of ventriculoperitoneal shunt with extrusion from the urethral meatus: case report and literature review. Pediatr Neurosurg 47:223–226PubMedCrossRef Pohlman GD, Wilcox DT, Hankinson TC (2011) Erosive bladder perforation as a complication of ventriculoperitoneal shunt with extrusion from the urethral meatus: case report and literature review. Pediatr Neurosurg 47:223–226PubMedCrossRef
16.
go back to reference Prasad VS, Krishna AM, Gupta PK (1995) Extrusion of peritoneal catheter of ventriculoperitoneal shunt through the urethra. Br J Neurosurg 9:209–210PubMedCrossRef Prasad VS, Krishna AM, Gupta PK (1995) Extrusion of peritoneal catheter of ventriculoperitoneal shunt through the urethra. Br J Neurosurg 9:209–210PubMedCrossRef
17.
go back to reference Surchev J, Georgiev K, Enchev Y, Avramov R (2002) Extremely rare complications in cerebrospinal fluid shunt operations. J Neurosurg Sci 46:100–103PubMed Surchev J, Georgiev K, Enchev Y, Avramov R (2002) Extremely rare complications in cerebrospinal fluid shunt operations. J Neurosurg Sci 46:100–103PubMed
18.
go back to reference Trojanowski T (2009) Hydrocephalus in adults (including normal pressure hydrocephalus syndrome). In: Sindou M (ed) Practical handbook of neurosurgery: rom leading neurosurgeons. Springer, Vienna, pp 429–440CrossRef Trojanowski T (2009) Hydrocephalus in adults (including normal pressure hydrocephalus syndrome). In: Sindou M (ed) Practical handbook of neurosurgery: rom leading neurosurgeons. Springer, Vienna, pp 429–440CrossRef
19.
go back to reference Yerkes EB, Rink RC, Cain MP, Leurssen TG, Casale AJ (2001) Shunt infection and malfunction after augmentation cystoplasty. J Urol 165:2262–2264PubMedCrossRef Yerkes EB, Rink RC, Cain MP, Leurssen TG, Casale AJ (2001) Shunt infection and malfunction after augmentation cystoplasty. J Urol 165:2262–2264PubMedCrossRef
Metadata
Title
Urinary bladder perforation, intra-corporeal knotting, and per-urethral extrusion of ventriculoperitoneal shunt in a single patient: case report and review of literature
Authors
Rashim Kataria
Virendra D Sinha
Sanjeev Chopra
Ashok Gupta
Nachiket Vyas
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 4/2013
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-012-1995-2

Other articles of this Issue 4/2013

Child's Nervous System 4/2013 Go to the issue