Complex complications following ventriculoperitoneal shunt placement in Syria: A case report on multiple bowel perforations, migration, and obstruction.

INTRODUCTION: In patients with hydrocephalus, the most effective technique since the early 1900s is through the implantation of a ventriculoperitoneal shunt (VPS). VPS can cause abdominal issues such as infection, bowel obstruction due to adhesions, or viscus perforation. In our patient, the combination of infection, bowel obstruction, multiple intestinal perforations, and anal migration of the shunt creates a unique blend of complications that may be caused by VPS. CASE PRESENTATION: A 17-year-old girl with a history of ventriculoperitoneal shunt placement presented with symptoms of bowel obstruction. During the anal palpation, the examiner felt a tubular object inside the rectal ampulla which was the shunt. Laparotomy revealed that the shunt catheter had perforated the jejunum, extended through the sigmoid colon, and into the rectum. The patient was treated with antibiotics and an external shunt was placed for three months, then placed through the jugular vein to the pericardial cavity. DISCUSSION: Hydrocephalus treatment often involves ventriculoperitoneal shunts (VPS) with complications such as abdominal issues, infections, and bowel perforation. These issues occur in 24 %-47 % of cases. In a rare case, a patient experienced infection, anal shunt migration, bowel obstruction, and three perforations, starting from the jejunum and extending to the rectum. The patient's history of appendectomy and previous shunt complications may have predisposed them to the perforation. CONCLUSION: The rare combination of infection, anal shunt migration, a bowel obstruction, and a perforations during hydrocephalus treatment highlights the critical need for comprehensive understanding of and monitoring for ventriculoperitoneal shunt complications. Prompt interdisciplinary intervention is essential due to the potential severity and mortality associated with these complex issues. Specific patient factors must be considered to optimize patient outcomes.

Attitude of Syrian students toward GAD patients: An online cross-sectional study.

Generalized Anxiety Disorder (GAD) is a prevalent condition and a significant cause of mental disability and poor quality of life. People with GAD have chronic worrying, restlessness, and discrimination from the general public; Little is known about the stigmatizing attitudes toward people with GAD among Syrian students. The questionnaires contained demographic data about age, gender, social status, personal stigma toward GAD scale, perceived stigma toward GAD scale, social distance with those with GAD, the participants' usual source of their knowledge about GAD, helpful interventions, and supporting information. A total of 1,370 replies were collected, but only 1,358 were used for analysis as 12 participants declined to complete the survey. About 44.1% of participants agreed that people with GAD could snap out of the problem, most of them being females (32.4% of the total population). Compared to medical students, more non-medical students (7.1% of the total population) believed that anxiety is a sign of personal weakness. This study demonstrated that Syrian college students showed a high level of stigmatizing and socially distancing attitudes toward people with GAD, particularly female and non-medical students.

Corrigendum: Attitude of Syrian students toward GAD patients: An online cross-sectional study.

[This corrects the article DOI: 10.3389/fpubh.2022.955321.].