Trans-anal protrusion of the distal end of ventriculo-peritoneal (VP) shunt – The role of ommaya shunt

Transanal protrusion of the distal end of ventriculoperitoneal shunt is an extremely rare complication associated with this procedure. Such complication only reported once in Malaysia since 1987. Instead of usual external ventricular drain (EVD) insertion as temporary CSF diversion post VP shunt removal, does Ommaya shunt play a better role in this? This unfortunate boy had undergone a right VP shunt due to communicating hydrocephalus secondary to bilateral intraventricular haemorrhage at 7 months old. He then experienced transanal VP shunt protrusion five months following the surgery. Apart from a literature review on the diagnosis and treatment for this rare complication, we further discuss the role of ommaya shunt as compared to usual EVD insertion. Early detection and prompt management are warranted to prevent further devastating damage from such complication. Although this single Case showed a favourable result, more studies are required to confirm the role of the Ommaya shunt.