A Case of Removal of an Infected Lumbo-peritoneal Shunt Tube that Strayed into the Ileum

Abstract

The patient was a 41-year-old man who underwent lumbo-peritoneal shunt (LPS) insertion for hydrocephalus due to cerebral hemorrhage at another hospital 2 years previously. He presented to our hospital with right frank pain. A plain CT scan of the abdomen revealed that a LPS tube had strayed into the end of the ileum just below the abdominal wall. Furthermore, misty mesentery was revealed around the subcutaneous tube. The patient was diagnosed as having retrograde subcutaneous fistula infection from the ventral LPS tube and was referred to our department for treatment. The lumbar LPS tube was removed by neurosurgery, and the infected subcutaneous fistula was dissected to the intestinal entry site by us. After that, the LPS tube was removed through an incision at the intestinal entry site and closed. The patient underwent neurosurgery again on postoperative day 26 because of cerebrospinal fluid leakage occurred after surgery. The patient was discharged on postoperative day 54. We report a rare case of a LPS tube straying into the ileum.