Transoral protrusion of a peritoneal catheter: a case report and literature review

Transoral protrusion of a peritoneal catheter is rare. Only two cases have been reported in the English literature. We now report the case of a 5-year -old girl who presented with a catheter that had been inserted 4 years prev iously, protruding from her mouth. Signs of cerebrospinal fluid infection o r peritonitis were absent. The peritoneal catheter was cut and externalized at the chest. The distal portion, which had perforated the stomach wall, w as removed using endoscopic procedures. After 3 weeks of antibiotic treatme nt, a new shunt was inserted. Analysis of 50 cases of bowel perforation ext racted from the English literature showed that among the suggested factors such as age, gender, nutritional state, history of abdominal surgery, and l ength and type of the catheter, age was the only predisposing factor. In th e treatment of bowel perforation by a peritoneal catheter, suspected shunt infection should be managed properly and contamination be minimized during removal of the peritoneal catheter.