NS-30: PERITONEAL CATHETER EXTRUSION OF A VENTRICULOPERITONEAL SHUNT FROM URETHRA IN A CASE OF POSTERIOR FOSSA TUMOR

A common neurosurgical procedure for hydrocephalus is ventriculoperitoneal (VP) shunting. Rates of complications of VP shunts are widely reported, ranging from 24% to 47%. Of which abdominal complications account for about 25%. Reported bowel perforation occur between 0.1% and 0.7% and the catheter may appear at one of the natural orifices, of which perianal protrusion is more common than perioral protrusion. In the literature only eight cases have been reported of urethral protrusion of the abdominal catheter of ventriculoperitoneal shunt. We have reported a case of protruding abdominal catheter from the Urethra. This seven months old female patient had ventriculoperitoneal shunt for hydrocephalus associated with posterior fossa tumor. The entire system has been removed, first the peritoneal catheter divided from an abdominal incision then the distal part extracted down from urethra while the proximal part extracted up from a scalp incision, antibiotic treatment was administered, and a new VP shunt was inserted in a second surgery. The postoperative course was quite well. To our knowledge this is an extremely rare complication of ventriculoperitoneal shunt and should to be dealt with in a wise manner to avoid further complications especially in a case like this with a posterior fossa tumor.