Knowing patient’s previous history, an asymptomatic intestinal or colic perforation or an anal fistula due to displacement and migration of ventriculoperitoneal shunt was suspected. we suspected that the shunt has perforated the colon, entered the colon and the rectum and eventually protruded through anus. Fortunately, like most cases, our case was asymptomatic and had no symptoms of peritonitis or other complications. after a consult with the neurosurgery team of the hospital, the patient was prepped for surgery.
The shunt’s proximal part was located using a C-Arm imaging and the location was marked on the patient’s chest (figure 5 ,6). Using a transverse incision, the proximal and metal part of the shunt was cut, separated and taken out. After taking out the proximal part, the distal part was removed from anus.
Fig.5 Locating the proximal part