Case report of migration of 2 ventriculoperitoneal shunt catheters to the scrotum: Use of an inguinal incision for retrieval, diagnostic laparoscopy and hernia repair

Abstract

HighlightsA ventriculoperitoneal shunt catheter migrated through an inguinal hernia into the scrotum.A single incision was used to for diagnostic laparoscopy, catheter removal and hernia repair.Prompt surgical removal of fractured shunt catheters is recommended to prevent organ injury.

Needle in a haystack: migration of ventriculoperitoneal shunt into scrotum of infant

“…The distal catheter of VPS can migrate into various body parts including abdominal wall, hollow viscous, vagina, mediastinum, bladder, scalp/sub-galeal space, neck, mouth, breast, thoracic cavity, pulmonary artery, intracardiac, and umbilicus [15]. The reported incidence of distal migration of VP shunt is 10%.…”

“…Migration into the scrotum is a very rare phenomenon that has been reported in nearly 30 case reports in the literature. Patent processus vaginalis can be present up to 30% of infant, and increasing abdominal pressure following shunt insertion contributes to the mechanism of shunt migration [15]. Most of these problems are due to free position of the lower end in the general peritoneal cavity and thus are able to migrate to any site.…”

“…A plain radiographic shunt series should be performed to assess integrity of VP shunt. Herniotomy with repositioning of the shunt tube is the treatment of choice [15].…”

“…After placement, however, complications are frequent, especially in children. Shunt migration through a patent processus vaginalis within the scrotal sac is a rare event, with only a few cases reported till date [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. We report a case of scrotal migration of VP shunt in a 1-year-old boy, through patent processus vaginalis, who had a background history of congenital hydrocephalus.…”

Tip of Peritoneal Catheter of Ventriculo- Peritoneal Shunt in Scrotum

“…The most suggested and acceptable treatment for such pediatric cases is direct repair of PPV and ligation of the sac, since increased CSF pressure prevents spontaneous occlusion of PPV (2)(3)(4)(5). Some even suggest assessment and prophylactic repair of the other side, when applicable.…”