Intestinal Perforation Caused by Lumboperitoneal Shunt Insertion Repaired with an Over-the-Scope Clip
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Lumboperitoneal or ventriculoperitoneal shunt insertion is a standard therapy for hydrocephalus that diverts cerebrospinal fluidfrom the subarachnoid space into the peritoneal cavity. Gastrointestinal perforations due to this procedure occur rarely; however,accepted treatment strategies have not yet been established. Hence, the most common treatment approaches are open surgery orspontaneous closure without endoscopy. We report the case of a small intestinal perforation in a 73-year-old-woman that occurredafter the insertion of a lumboperitoneal shunt. A positive cerebrospinal fluid culture and high cerebrospinal fluid white blood cellcount indicated a retrograde bacterial infection, and computed tomography revealed that the peritoneal tip of the shunt catheter waslocated in the lumen of the gastrointestinal tract. We repaired the perforation endoscopically using an over-the-scope clip, and thepatient’s recovery was uneventful. Use of an over-the-scope clip could be an effective and minimally invasive treatment for intestinalperforations caused by lumboperitoneal or ventriculoperitoneal shunt insertion.
Abstract
Lumboperitoneal or ventriculoperitoneal shunt insertion is a standard therapy for hydrocephalus that diverts cerebrospinal fluidfrom the subarachnoid space into the peritoneal cavity. Gastrointestinal perforations due to this procedure occur rarely; however,accepted treatment strategies have not yet been established. Hence, the most common treatment approaches are open surgery orspontaneous closure without endoscopy. We report the case of a small intestinal perforation in a 73-year-old-woman that occurredafter the insertion of a lumboperitoneal shunt. A positive cerebrospinal fluid culture and high cerebrospinal fluid white blood cellcount indicated a retrograde bacterial infection, and computed tomography revealed that the peritoneal tip of the shunt catheter waslocated in the lumen of the gastrointestinal tract. We repaired the perforation endoscopically using an over-the-scope clip, and thepatient’s recovery was uneventful. Use of an over-the-scope clip could be an effective and minimally invasive treatment for intestinalperforations caused by lumboperitoneal or ventriculoperitoneal shunt insertion.
참고문헌 (10)
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