[EngO6-2] A unique strategy for large bowel perforation with ventriculo-peritoneal shunt: Conversion to ventriculo-atrial shunt
Since large bowel perforation can lead to critical sepsis, urgent intervention including surgery is indispensable in order to control to systemic infection. Here, we present a strategy for large bowel perforation with ventriculo-peritoneal shunt.
A 74-year-old Japanese woman presented with lower abdominal pain, fever, and disordered consciousness. She had had a history of cerebral aneurysm clipping and ventriculo-peritoneal shunt (V-P shunt) placement due to aneurysm rupture followed by subarachnoid hemorrhage 3 years before. She was diagnosed as large bowel perforation and bacterial meningitis transmitted by V-P shunt according to her clinical findings. We performed sigmoidectomy and externalization of the shunt and consequently replaced it with ventriculo-atrial shunt (V-A shunt) (Figure 1). Her postoperative course was quite well and she was discharged without major complications.
We discuss about the management of bowel perforation related to VP shunt including the utility of V-A shunt as an alternative based on our experience and preceding literatures.
A 74-year-old Japanese woman presented with lower abdominal pain, fever, and disordered consciousness. She had had a history of cerebral aneurysm clipping and ventriculo-peritoneal shunt (V-P shunt) placement due to aneurysm rupture followed by subarachnoid hemorrhage 3 years before. She was diagnosed as large bowel perforation and bacterial meningitis transmitted by V-P shunt according to her clinical findings. We performed sigmoidectomy and externalization of the shunt and consequently replaced it with ventriculo-atrial shunt (V-A shunt) (Figure 1). Her postoperative course was quite well and she was discharged without major complications.
We discuss about the management of bowel perforation related to VP shunt including the utility of V-A shunt as an alternative based on our experience and preceding literatures.