Perforation of the gastrointestinal tract by a ventriculoperitoneal shunt catheter with anal exteriorization in an adult patient: case report.

Ventriculoperitoneal shunt (VPS) is widely utilized in the management of hydrocephalus, although it is associated with various complications, predominantly infectious or mechanical. Intestinal perforation with anal exteriorization of the catheter is a rare but potentially lethal event. We report a 29-year-old male with a history of previously treated arteriovenous malformation and VPS implantation since 2018 presented with anal exteriorization of the catheter. He reported prior episodes of catheter protrusion, inadvertent manual traction, and the discharge of foul-smelling fluid. Imaging suggested distal migration of the catheter into the gastrointestinal tract. He underwent exploratory laparotomy with catheter removal and sigmoid repair, in conjunction with neurosurgery for the removal of the proximal portion of the VPS. The patient had an uneventful postoperative recovery. This case underscores the critical importance of prompt assessment and surgical intervention in the rare complication of intestinal perforation caused by a VPS catheter, especially in cognitively impaired patients.