Abstract
The patient was a 20-year-old man who had undergone ventriculo-peritoneal shunt implantation following surgery for myeloeningiocele as a newborn. The V-P shunt was exchanged because of hydrocephalus when the patient was 8 years old. Granulation had been noticed in the V-P shunt insertion wound three months earlier, and the wound had begun to discharge pus from a month earlier. Removal of the V-P shunt tube was scheduled, as infection of the V-P shunt system was suspected. Preoperative CT showed migration of the peritoneal shunt tube into the transverse colon, however there was no tenderness of the abdomen suggestive of infectious peritonitis. Laparoscopic surgery revealed penetration of the peritoneal shunt tube into the transverse colon, and laparotomy with a small incision was subsequently performed for repair of the transverse colon wall after removal of the peritoneal shunt tube. The infection of the V-P shunt insertion wound was controlled by systemic antibiotic administration. V-P shunt implantation was planned when hydrocephalus was detected again. Bowel penetration by a peritoneal shunt tube in a V-P shunt system is rare, and in our case, laparoscopic surgery was useful for the diagnosis and treatment of penetration of the transverse colon by a peritoneal shunt tube of a V-P shunt system.
