COLONIC PERFORATION BY VENTRICULOPERITONEAL SHUNT TUBING - A CASE OF SUSPECTED SILICONE ALLERGY

BACKGROUND A case of colonic perforation by a ventriculoperitoneal shu nt is presented in a patient with several previous complications assoc iated with shunt tubing. CASE DESCRIPTION Initially managed by intrave nous antibiotics, shunt externalization, and colonoscopy, the entire v entriculoperitoneal shunt system was subsequently replaced after cereb rospinal fluid cultures had grown Propionibacterium acnes and Streptoc occus sanguis organisms. The patient has had three episodes of skin br eakdown over his shunt tubing (two prior and one subsequent to colonic perforation) without evidence of shunt infection or malfunction. CONC LUSIONS The etiology of these complications is consistent with silicon e tubing allergy. Replacement with a polyurethane system produced no s imilar complications thus far, which further supports a possible silic one allergy to the ventriculoperitoneal shunt and possible etiology of this patient's colonic perforation. (C) 1998 by Elsevier Science Inc.