Small Bowel Obstruction and Enterococcus Meningitis: Rare Complications of Ventriculoperitoneal Shunt Placement

Vincent B Gonzalez; Lisa M Pace; Matthew Johnson; Darren Klawinski

doi:10.7759/cureus.40575

Small Bowel Obstruction and Enterococcus Meningitis: Rare Complications of Ventriculoperitoneal Shunt Placement

Cureus. 2023 Jun 17;15(6):e40575. doi: 10.7759/cureus.40575. eCollection 2023 Jun.

Authors

Vincent B Gonzalez¹, Lisa M Pace¹, Matthew Johnson², Darren Klawinski³

Affiliations

¹ Pediatrics, University of Florida College of Medicine - Jacksonville, Jacksonville, USA.
² Pediatrics, University of Florida College of Medicine - Gainesville, Gainesville, USA.
³ Pediatric Hematology/Oncology, Nemours Children's Health System, Jacksonville, USA.

Abstract

A ventriculoperitoneal (VP) shunt is a commonly used mechanical device indicated for congenital and acquired hydrocephalus in children. Although VP shunt failure is not uncommon, the symptomatology and cause of failure can vary. In this case, we describe intestinal obstruction in a three-year-old Caucasian female with a history of Pilomyxoid Astrocytoma and VP shunt placement for the management of hydrocephalus. Surgical exploration revealed ischemia of the terminal ileum secondary to VP shunt tubing-induced adhesions requiring bowel resection. A secondary VP shunt infection due to Enterococcus faecalis was also noted. Our case highlights a unique presentation of intestinal obstruction and infection that should serve to increase provider suspicion when evaluating patients presenting with abdominal distention and pain with presence of a VP shunt.

Keywords: endoscopic third ventriculostomy; gram-positive meningitis; pilomyxoid astrocytoma; small-bowel obstruction; ventriculoperitoneal shunt.

Publication types

Case Reports