Laparoendoscopic removal of peroral extrusion of a ventriculoperitoneal shunt.

INTRODUCTION: Ventriculoperitoneal shunts for hydrocephalic children are known to cause serious complications such as GI perforation. Peroral extrusion of the peritoneal part of a ventriculoperitoneal shunt is very rare, and management could be a challenge. MATERIALS AND SURGICAL TECHNIQUE: An 11-year-old girl presented with peroral extrusion of the distal end of a ventriculoperitoneal shunt tube. Endoscopy and imaging studies showed that the peritoneal end had perforated the stomach and then extruded from the mouth. We used a surgical technique that combined endoscopy and laparoscopy to manage this rare complication. DISCUSSION: Peroral extrusion of a ventriculoperitoneal shunt tube occurs secondary to perforation of the upper GI tract. Managing this condition involves removing the shunt tube, attention to the perforated viscus and associated infection. A combination of endoscopy and laparoscopy provided superior views, enabled identification of the site and size of the perforated viscus, and facilitated the uneventful removal of the tube.