GASTRIC PERFORATION DUE TO VENTRICULO-PERITONEAL SHUNT

Gastric perforation is a complication that can arise from ventriculo-p eritoneal (VP) shunting. Careful examination of a newborn girl admitte d to our department revealed several neurological problems. A VP shunt was inserted under direct visualization, leaving 20 cm of the cathete r in the peritoneal cavity. The infant was discharged 6 days after sur gery and readmitted 4 months later due to increasing head circumferenc e and severe malnutrition. Physical examination revealed a soft abdome n, normal peristalsis, and no signs of peritoneal irritation. The pati ent was submitted to exploratory surgery, which showed that the cathet er had penetrated about 6 cm into the stomach. The VP shunt was remove d and replaced by a left ventriculo-atrial system. The patient evolved well and was discharged 5 days later. Probable causes of the perforat ion are discussed in this paper.