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Background:Ventriculo-peritoneal shunting is an effective treatment for hydrocephalus,bowel perforation by peritoneal catheters is an extremely rare complications associated with this procedure.Case presentation:We report a 9-year-old girl who had anal VP shunt protrusion two months following surgery and review the literature to understand the diagnosis and treatment for this rare complication.A PubMed search using the keywords ‘bowel perforation’ and ‘Escherichia coii ventriculitis’ was performed and citations were reviewed.Conclusions:Neurosurgeons should be alert to early diagnosis and appropriate treatment of this condition to prevent infectious and neurological complications.