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Boletín Clínico de la Asociación Médica del Hospital Infantil del Estado de Sonora

2023, Number 2

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Bol Clin Hosp Infant Edo Son 2023; 40 (2)

Rectal migration of the distal catheter of the ventriculoperitoneal shunt valve. Case report

Balvanera RÉA, Soto VMN, Leyva CDM

Language: Spanish
References: 15
Page: 49-52
PDF size: 185.03 Kb.


ABSTRACT

Complications of ventricular shunt in pediatrics are reported in 24 to 47% of cases. Distal catheter migration through the rectum is a very rare complication, with a great impact on the patient's morbidity and mortality. This clinical case present a female infant aged 1 year 7 months, with a history of communicating hydrocephalus at birth, requiring placement of a ventricular peritoneal shunt valve at 20 days of life. He went to the emergency department for presenting exteriorization of the distal catheter of the ventriculoperitoneal valve through the rectum. His vital signs were normal. The physical examination revealed no neurological alterations, no evidence of peritoneal irritation, and an 8-cm exit from the distal catheter through the anal orifice. A radiographic series was carried out confirming the diagnosis, for which the neurosurgery service was consulted, transferring the patient to the operating room urgently. The distal catheter was removed and a broad-spectrum antibiotic scheme was started. Subsequently, placement of a new shunt valve was scheduled, which was performed without complications. Migration of the distal ventriculoperitoneal shunt catheter through the rectum is a rare complication in pediatrics. Due to its low frequency, there is no established management, various recommendations have been proposed, however, management should always be individualized, always opting for the most effective but least invasive procedure.


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