[A case of sigmoid colon perforation by a V-P shunt tube resulting in pneumocephalus].

A 47-year-old male presented with headache 3 years after V-P shunt procedure. Initial CT revealed pneumocephalus, and a shunt tube migration into the sigmoid colon was detected by contrast medium injection into the shunt tube. The patient's condition was complicated with bacterial meningitis, and the infected shunt tube was removed. After chemotherapy, the V-P shunt was reinstalled. This is the first case showing pneumocephalus occurring as an initial symptom of bowel perforation by a V-P shunt tube. In this case, the abdominal tip of the shunt tube had been anchored at the same place for 6 months before bowel perforation. This finding may support the hypothesis that fibrous encasement of a shunt tube may trigger abdominal complications, as previously suggested.