A unique strategy for large-bowel perforation with ventriculoperitoneal shunt: Conversion to ventriculoatrial shunt: A case report

INTRODUCTION: Large-bowel perforation can lead to critical sepsis, and urgent intervention including surgery is indispensable to control systemic infection. Here, we describe a strategy for large-bowel perforation using a ventriculoperitoneal shunt. CASE PRESENTATION: A 74-year-old Japanese female with a history of cerebral aneurysm clipping and ventriculoperitoneal shunting due to aneurysmal subarachnoid hemorrhage presented with lower abdominal pain, fever, and disturbed consciousness. Clinical findings indicated a diagnosis of large-bowel perforation and ventriculoperitoneal shunt-transmitted bacterial meningitis. Thus, sigmoidectomy and shunt externalization were performed, and the ventriculoperitoneal shunt was converted to a ventriculoatrial one. CONCLUSION: Based on our experience and the literature, we successfully discuss bowel perforation management with respect to the ventriculoperitoneal shunt, including the utility of the ventriculoatrial shunt as an alternative.