Spontaneous extrusion of peritoneal catheter of ventriculoperitoneal shunt through the intact abdominal wall: Report of two cases
A 14-year-old boy presented with extrusion of peritoneal end of the VPS catheter through the intact abdominal wall []. Eight years back, he had undergone medium-pressure VPS surgery for hydrocephalus caused by posterior fossa pilocytic astrocytoma. Five days prior to his current admission, he noticed erosion of the upper abdominal wall, through which a part of the peritoneal catheter extruded out.\nOn admission, both of them were conscious and had no neurological deficits. In both cases, physical examination showed an old scar on the right upper abdomen. The peritoneal catheter protruded from the upper abdominal wall near the epigastrium away from the previous surgical incision.\nLaboratory examinations were essentially within normal limit. After abdominal ultrasonography (USG) did not show any signs of intra-abdominal pathology, the shunts were removed immediately. The peritoneal catheter was disconnected from the valve chamber by a small skin incision placed behind the ear under local anesthesia and was pulled out from the abdominal wall. Broad-spectrum antibiotic treatment was started. CSF culture was negative. Computed tomography (CT) of the head revealed dilated ventricles on the postoperative day 3. A new VP shunt was put on the opposite side. A postoperative CT showed that the size of the ventricles had decreased. The patients were discharged after 8 days with the advice for periodical checkups. At 6-months follow-up, both are doing well.