Extrusion of the Distal Catheter From the Umbilicus: A Case Report of a Rare Complication After Ventriculoperitoneal Shunt and Its Management

Abstract

Spontaneous extrusion of the distal catheter from the umbilicus following a ventriculoperitoneal shunt (VPS) for the treatment of hydrocephalus is an extremely rare complication. Here, we describe an 8-years-old boy who underwent a VPS for communicating hydrocephalus and thereafter the distal part of the catheter was extruded through the umbilicus. The extrusive part of the peritoneal catheter was successfully cut off with a laparoscope, keeping the remaining catheter in place and functional. The subsequent recovery process was uneventful. To the best of our knowledge, there have been no reports of using laparoscopy to cut the protruding part and replace the shunt end. By keeping the function of the original shunt pipe, this case report offers an innovative and informative approach to treating this complication.

Extrusion of the distal ventriculoperitoneal shunt catheter through the umbilicus: a systematic literature review from 1973 to 2021

“…This review consisted of a total of n=24 cases (12 males, 12 females) of trans-umbilical extrusion of the distal VPS catheter, and all were children below the age of 13-years. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Nineteen manuscripts were published and available in the English language. 11,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] One of the manuscripts was published and available in a language other than English.…”

“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Nineteen manuscripts were published and available in the English language. 11,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] One of the manuscripts was published and available in a language other than English. 12 Fourteen cases of extrusion of the distal VPS catheter through the umbilicus were published as case reports.…”

“…[31][32][33] The demographics, clinical and operative details of n=24 children included in the present review of the management of extrusion of the distal VPS catheter through the umbilicus are provided in Table 1. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Results of the present review on the management of trans-umbilical extrusion of the distal VPS catheter are summarized in Table 2.…”

“…17 In two (8.3%) of children, the indication for VPS insertion was others. 27,28 The age of children at the time of initial VPS insertion ranged from 1 day to 7.6 years with a median of 2 (22.31 SD) months. In four-fifths (n=19) of children, the initial VPS catheter was inserted during the first 6-months of life.…”

“…The present manuscript is a systematic review of the literature of n=24 cases of trans-umbilical extrusion of the distal VPS catheter to highlight the demographics, clinical characteristics, surgical procedures offered for the management, and the outcome. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]…”