Science and Education Publishing American Journal of Medical Case Reports 2374-216X 5 3 2017 3 30 Series of 3 Cases of Silent Colonic Perforation by Ventriculoperitonal Shunt Catheter Prolapsing through Anus, an Infrequent Complication: A Case Report 59 61 EN Qassim Al Hinai Neeraj Salhotra Department of Neurosurgery, Khoula Hospital, Muscat, Oman, PO box 90, Postal Code 116 Munthir Al Zabin Azmat Ali Salim Al Abri Mohammad Hashim S.D Lad AJMCR2017534 10.12691/ajmcr-5-3-4 2016 12 6 2017 1 26 2017 3 28 The ventriculoperitoneal shunt has been the preferred therapy for chronic hydrocephalus for a long time. Complications of this therapy include pseudocyst formation, perforation of the gastrointestinal tract, penetration into solid organs/abdominal wall, protrusion outside the body, disconnection and infection. Bowel perforation is rare complication of VP shunt placement [8]. Silent colonic perforation by ventriculoperitoneal shunt catheter and later patient presenting with catheter prolapsing from anal opening is seen less frequently [1]. We had 3 children 1-3 years old a case of hydrocephalus with ventriculoperitoneal shunt presenting in above scenario. Patients were completely asymptomatic with no features of toxemia indicating a chronic process [2]. Treatment involves pediatric surgical help in removing the shunt catheter, waiting for a sterile cerebrospinal fluid sample via repeated cultures and replacement of shunt catheter in a different quadrant in abdominal cavity.