Protrusion Trans anale de la Partie Distale d’Un Cathéter de Dérivation Ventriculo-Péritonéale Sans Péritonite chez un Nouveau-né : Une Complication Rare
Trans-anal Protrusion of the Distal End of a Ventriculoperitoneal Shunt Without Peritonitis in a Neonate: An Unusual Complication
DOI :
https://doi.org/10.5281/hra.v3i2.6383Mots-clés :
Protrusion anale, perforation gastrique, cas clinique, hydrocéphalie, dérivation ventriculo-péritonéaleRésumé
ABSTRACT Ventriculoperitoneal shunting is the standard of care for hydrocephalus, yet carries a risk of complications throughout a patient’s lifetime. Here we describe the case of a 4-week-old child who presented with the distal end of her shunt protruding through the anus without signs of peritonitis. She was neurologically intact on examination without signs of meningitis, and cerebrospinal fluid examination were negative for infection. She underwent surgical removal of the distal shunt followed by replacement after a course of prophylactic antibiotics. The neonate later died from meningitis two weeks after shunt replacement despite the initially negative CSF tests. Despite its rarity, bowel perforation is a potentially fatal complication of shunt placement and should be treated in an urgent manner with surgical repair and prophylactic antibiotics until ventriculitis is ruled out. RÉSUMÉ La dérivation ventriculo-péritonéale est le traitement standard pour la prise en charge des hydrocéphalies. Cette modalité thérapeutique peut-être source de complications diverses. Nous rapportons le cas d’une fillette de 4 semaines qui a présenté une protrusion de la partie distale du cathéter de dérivation ventriculo-péritonéale à travers l’anus, sans signe de péritonite. L’examen neurologique était dans les limites de la normale sans signe d’irritation méningé. L’analyse cytobactériologique du liquide cérébro-spinal n’a pas montré de signe d’infection. Nous avons procédé au changement du dispositif de dérivation ventriculo-péritonéale après une antibiothérapie prophylactique. La fillette est décédée deux semaines après le changement du dispositif de dérivation ventriculo-péritonéale, dans un contexte de méningite malgré les analyses initiales négatives du liquide cérébro-spinal. Bien que rare, la perforation intestinale est une complication des dérivations ventriculo-péritonéales. Elle peut être cause de décès et doit de ce fait être pris en charge de façon urgente avant la survenue de ventriculite.Références
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© Bikono Atangana Ernestine Renée, Berjo Takoutsing, Magadji Jean Paul, Alain Jibia, Eyenga Victor Claude, Ignatius Esene 2025
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