Transoral Migration of a Ventriculoperitoneal Shunt (VPS) Catheter in a Six-Month-Old Boy: A Case Report
Mahamat Mahamat Saleh
Pediatric Surgery Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dentistry, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Oumar Abakar Mahamed *
Department of Epidemiology, Clinical Research and Community Health, Hassan II University Hospital, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
Hajar Dardar
Pediatric Surgery Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dentistry, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Loula Djama Miguil
Pediatric Surgery Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dentistry, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Ahmat Tidjani Mahamat
Pediatric Surgery Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dentistry, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Ibrahim Mahamat Ahmat
Pediatric Surgery Department, Amirou Boubacar Diallo University Hospital, Abdou Moumini University, Niamey, Niger.
Yahia Bennani
Pediatric Surgery Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dentistry, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Abdoulaye Affadine Ismail
Department of Epidemiology, Clinical Research and Community Health, Hassan II University Hospital, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
Zineb Oudrhiri
Pediatric Surgery Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dentistry, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Naoufel Boumahdi
Pediatric Surgery Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dentistry, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Othmane Alaoui
Pediatric Surgery Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dentistry, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Abdelhalim Mahmoudi
Pediatric Surgery Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dentistry, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Khalid Khattala
Pediatric Surgery Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dentistry, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
Youssef Bouabdallah
Pediatric Surgery Department, Hassan II University Hospital, Faculty of Medicine, Pharmacy, and Dentistry, Sidi Mohamed Ben Abdallah University, Fez, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Ventriculoperitoneal Shunt (VPS) is the gold standard for the treatment of hydrocephalus. Gastrointestinal perforation is rare, and perforation above the angle of Treitz is exceptional. We report a rare case of a VPS catheter externalized through the mouth in a six-month-old boy.
Case Presentation: This was a six-month-old patient with a history of spina bifida, for which he underwent surgery on his sixth day of life, followed by a ventriculoperitoneal shunt (VPS) for malformation-related tri-ventricular hydrocephalus on his tenth day of life. The reason for consultation was the protrusion of the VPS catheter through the mouth. The patient was admitted to the operating room for an exploratory procedure, and the end of the catheter protruding from the oral cavity was cut off under sterile conditions. The surgical exploration revealed multiple adherences between the loops. During adhesiolysis, the catheter was accidentally dislodged and ended up in the abdomen. We tried to locate the perforation but were unsuccessful. Conservative treatment was administered. The postoperative course was uneventful, and the patient was discharged on the eighth day.
Conclusion: Exteriorization of the VPS through the mouth is an extremely rare complication. Management requires emergency surgery, involving both a gastrointestinal exploration and verification of the VPS.
Keywords: Hydrocephalus, Ventriculoperitoneal Shunt (VPS), catheter migration, gastro-intestinal perforation, infant, case report