Transanal Extrusion of a Cystoperitoneal Shunt Catheter in a Child: A Case Report and Review of the Literature

Cystoperitoneal shunt and ventriculoperitoneal shunt are commonly used cerebrospinal fluid diversion procedures in neurosurgery. Although generally effective, these procedures are associated with several complications, including shunt migration. Transanal extrusion of the distal catheter after shunt migration is a rare but potentially serious complication, reported in approximately 0.1%-0.7% of shunt procedures, and is usually associated with bowel perforation and a risk of retrograde central nervous system infection. We report the case of a seven-month-old child who developed transanal extrusion of the distal catheter six months after cystoperitoneal shunt placement for a symptomatic arachnoid cyst. The shunt was successfully removed, and cerebrospinal fluid analysis showed no evidence of infection. Follow-up was favorable, with no recurrence of the arachnoid cyst; therefore, shunt replacement was not required. Here, we discuss the mechanism, predisposing factors, and principles of management.