Gastric perforation due to distal catheter migration in an adult patient with a ventriculoperitoneal shunt: A case report

Background: Ventriculoperitoneal shunts (VPSs) are used for the treatment of hydrocephalus. Among their complications, distal catheter migration with gastric perforation is exceptionally rare. Case Description: The case of a 33-year-old male with a history of VPS placement who attended the hospital with fever and seizures is presented. Gastric perforation secondary to distal catheter migration was diagnosed by computed tomography and upper gastrointestinal endoscopy. Microorganisms were isolated from the valve reservoir, whereas cerebrospinal fluid cultures obtained by lumbar puncture were negative. Antibiotic therapy was administered, followed by complete removal of the shunt system, without the need for gastric wall repair. No postoperative complications were reported. After negative intraoperative cultures were obtained, a new VPS placement was performed. Conclusion: Gastric perforation related to VPS is uncommon and should be considered in patients with unexplained or nonspecific symptoms who carry a VPS. Management should be tailored to the patient’s clinical and infection status.