# Intracolonic migration and anal protrusion of the abdominal catheter of a Ventriculoperitoneal shunt in a patient with diverticulosis: a case report

## TL;DR

A 72-year-old woman with a VP shunt and diverticulosis had a rare complication where the shunt migrated into her colon and protruded from the anus, requiring emergency surgery.

## Contribution

This case report highlights a rare VP shunt complication in an elderly patient with diverticulosis, emphasizing the need for early detection and surgical intervention.

## Key findings

- The VP shunt catheter migrated into the sigmoid colon through a ruptured diverticulum and protruded from the anus.
- Emergency removal of the shunt and laparoscopic intervention prevented meningitis and sepsis.
- The case underscores the importance of managing rare VP shunt complications in elderly patients with diverticulosis.

## Abstract

Ventriculoperitoneal (VP) shunt migration and anal protrusion is a very rare complication of VP Shunt Implantation, which is more often seen in children then adults. We present a case of a 72-year-old female with severe diverticulosis and anal protrusion of VP shunt, 2 years after placement. She presented herself in our emergency room with chronic abdominal pain. Upon further examination, we observed a transanal distal catheter protrusion. Due to the imminent risk of developing meningitis, we opted for emergent removal of the VP Shunt. Simultaneously, through an explorative laparoscopy, the visceral surgeon removed the distal VP shunt catheter, which entered the sigmoid colon through a ruptured diverticulum. This case highlights the importance of recognizing and managing rare complications of VP shunts, particularly in elderly patients with diverticulosis. Early detection and appropriate surgical intervention are crucial in preventing severe consequences such as meningitis and sepsis, as well as ensuring a successful outcome.