Migration of a ventriculo-peritoneal shunt catheter into a back incision of a patient with previous spinal fusion

Abstract

In abandoned VP shunts, migration into a non-sterile cavity dictates prompt removal, especially after symptoms of infection present. Additionally, careful monitoring for signs of peritonitis or other symptoms for a dedicated period of time is necessary. To the authors' best knowledge, this is the first case of an occult shunt migration through the patient's back that presented with a weeping abscess.

Spontaneous Migration of a Ventriculoperitoneal Shunt into the Venous System: A Multidisciplinary Approach

“…Obesity and previous shunt surgery are more specific independent risk factors for catheter migration [7]. Distal catheter migration of VP shunts most commonly arises from peritoneal perforation and has been observed in a variety of organ systems such as lumbar soft tissue penetration following discectomy, bladder perforation and extrusion through the urethral orifice, ascension into the oropharyngeal cavity through the gastrointestinal tract, and descension into the scrotum through a congenital remnant [8][9][10][11]. Spontaneous intracardiac migration, such as the basis of this case report, has been documented previously in the literature, albeit rarely [12][13][14][15][16][17].…”

A Review of Ventriculoperitoneal Shunt Migration

“…While the umbilicus dominates as the principle site of shunt migration through the abdominal wall, isolated case reports do report additional sites. One such case report involved shunt tubing that presented through a patients back at the site of previous lumber spinal fusion surgery [19].…”