V-P Shunt Tubeが胃に穿通し逆行性髄膜炎を起こした1例

Gastric Perforation in Ventriculo-Peritoneal Shun:a Case Report

Ⅰ．はじめに

　脳室腹腔短絡術（V-P shunt）は脳神経外科手術のうち最も頻度の高い予術の1つであるが，その重大な合併症の1つに腹側チューブによる臓器穿通がある．筆者らは剖検にてチューブが胃内に穿通し，これによる逆行性髄膜炎を併発したと考えられる症例を経験したので文献的考察を加え報告する．

The case is a 69-year-old female who was admitted to our hospital under the diagnosis of normal pressure hydrocephalus secondary to cerebral infarction. V-P shunt was performed and postoperative course was uneventful until 7 months after operation, when she developed meningitis. Since then the level of consciousness became gradually worse down to akinetic mutism. Two years and 3 months after the operation she died of pneumonia. At autopsy peritoneal end of the shunt tube was found to have perforated the antero-inferior wall of the stomach.