Abstract
A two-year-old girl who had undergone ventriculo-peritoneal shunt (VPS) surgery visited our hospital because of tube protrusion through the anus. On admission, she had no fever and did not show any sign of peritonitis or meningitis. Although abdominal X-ray findings confirmed anal protrusion of the shunt tube, no free air was detected. Laboratory data did not show any sign of peritonitis. She was diagnosed as having intestinal perforation by the VPS tube. A laparoscopic exploration revealed that the intraperitoneal VPS tube was completely covered by fibrous tissue, and had penetrated the sigmoid colon without stool leakage. The tube was exposed and cut at the right anterior chest wall. The proximal part of the tube was exteriorized, and the distal part was removed transanally. Fibrous tissue around the tube was laparoscopically ligated and cut. Enteral feeding was restarted shortly after surgery, and operation-related intraabdominal complications did not occur. The laparoscopic approach was very useful for peritoneal exploration in case of intestinal perforation due to VPS, and its treatment may be appropriated by our aforementioned procedures.
