Spontaneous Colonic Perforation Due to Ventriculoperitoneal Shunt Migration in an Adult: A Case Report

A Ventriculoperitoneal (VP) shunt is a Cerebrospinal Fluid (CSF) drainage system that typically consists of a tube with a valve to regulate pressure. It starts in the brain’s ventricular system and functions to reduce elevated intracranial pressure by diverting excess CSF to an external absorptive area, commonly the peritoneal cavity. We report a case of a 22-year-old male patient who underwent VP shunting for the management of post-traumatic communicating hydrocephalus, six months after which he noticed the distal shunt tip projecting out through the anal opening. Laboratory tests, including complete blood count, C-reactive protein level, blood culture, and CSF analysis, were within normal limits. Computed Tomography (CT) abdomen and pelvis revealed the distal part of the catheter within the lumen of the descending and sigmoid colon. We managed this case by removing the entire shunt system and achieving primary closure of the descending colonic perforation. Shunt migration may result in severe complications, including faecal contamination and the development of infections such as ascending meningitis or ventriculitis. This case report underscores one of the rarest yet most serious adverse outcomes associated with VP shunt placement. The VP shunt remains the mainstream treatment for CSF disordered mechanics, although they are well-known to be associated with many potential complications. In clinical practice, early identification of such complications can avoid life-threatening sequelae.