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Enterocutaneous fistula secondary to retained intraperitoneal fragment of a ventriculoperitoneal shunt in a 48-year-old man with spina bifida
  1. Andrew Webster,
  2. Rishabh Singh and
  3. John Stebbing
  1. General Surgery, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
  1. Correspondence to Andrew Webster; a.r.webster{at}


We report the case of a 48-year-old man with spina bifida and history of previous ventriculoperitoneal (VP) shunt placement for hydrocephalus. On attempted removal of the shunt 2 years prior to presentation at a neurosurgical unit, the peritoneal component was left in situ due to difficulties with removal. He presented acutely to our general surgical department with an enterocutaneous fistula precipitated by the retained fragment discharging to the right upper abdominal quadrant that required urgent surgical intervention. Although abdominal complications of VP shunts are documented, there is minimal literature as to the risks of remnant catheters being left in situ. This case demonstrates the possible risks with retained VP shunt catheters and the necessity to remove any redundant foreign bodies to prevent significant delayed complications.

  • general surgery
  • hydrocephalus
  • healthcare improvement and patient safety
  • gastrointestinal surgery
  • neurosurgery

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  • Contributors Case report written by AW, and reviewed and edited by RS and JS. RS was the operating surgeon and provided operative details. JS was the consultant in charge of the patient’s care who also helped with the writing of the case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.