Migration of distal ventriculoperitoneal shunt catheter into an inguinal hernia sac in an adult patient: a case report and literature review

Trang, Jason; McHarg, David; Owler, Brian

doi:10.1111/ans.16741

Cited by 3 publications

(15 citation statements)

References 8 publications

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“… 2 Scrotal migration through the inguinal canal is a rare but possible complication of VP shunt in adults and it has been described in some cases throughout the literature. 6 – 8 It is believed that scrotal migration of VP shunt occurs mostly in children due to the patency of the processus vaginalis combined with smaller peritoneal cavity. 8 , 13 However, in some adult patients, this structure remains open therefore increasing their chances of VP shunt migration through the inguinal canal.…”

Section: Discussionmentioning

confidence: 99%

“… 8 , 13 However, in some adult patients, this structure remains open therefore increasing their chances of VP shunt migration through the inguinal canal. 7 , 8 Other explanations such as intestinal peristalsis have being proposed in the literature as a risk factor for catheter migration. 14 , 15 However, to our knowledge, no article has reported a catheter migration into the scrotal sac caused by intestinal peristalsis.…”

Section: Discussionmentioning

confidence: 99%

“… 6 – 8 This later complication is more frequently seen in pediatric patients due to the patency of the processus vaginalis. 5 , 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8] This later complication is more frequently seen in pediatric patients due to the patency of the processus vaginalis. 5,7,8 However, it is thought that 15%-30% of adult patients still have an unobliterated processus vaginalis. 8 Moreover, hydrocephalus being a common pathology encountered in neurosurgery, 9 it is important to raise awareness about the possible scrotal migration of VP shunt and provide solutions on how to manage this presentation.…”

Section: Introductionmentioning

confidence: 99%

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Unusual presentation of a common neurosurgical shunt procedure in an adult patient

Sonfack

Tarabay

Shédid

et al. 2022

SAGE Open Medical Case Reports

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Ventriculoperitoneal shunt surgery is one of the treatments of hydrocephalus. It involves placing a shunt from the cerebral ventricles to the peritoneum serving as a drainage point. Infection and catheter blockage are some of the possible complications resulting from this procedure. In some cases, other incidents such as peritoneal shunt migration have also been described. Here, we present the case of a 73-year-old male patient treated with ventriculoperitoneal shunt for a normal pressure hydrocephalus. After an initial blockage of the ventricular catheter, a revision surgery was performed with only mild improvement of his neurological symptoms. A repeat shunt series X-ray showed a migration of the distal catheter into the scrotum through an inguinal hernia. He was successfully treated with a laparoscopic repair of the inguinal hernia and repositioning of the distal catheter into the peritoneal cavity. Scrotal migration and hydrocele are unusual presentations and complications of ventriculoperitoneal shunts. Close follow-up of patients with a ventriculoperitoneal shunt should be performed if they experience worsening of their neurological symptoms. Shunt integrity should be assessed and any complications should be managed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“… 6 – 8 This later complication is more frequently seen in pediatric patients due to the patency of the processus vaginalis. 5 , 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Unusual presentation of a common neurosurgical shunt procedure in an adult patient

Sonfack

Tarabay

Shédid

et al. 2022

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

show abstract

“…Other complications are shunt blockage, infection, shunt erosion, and extrusion [11]. VP shunts might cause intracerebral haemorrhage and peritoneal catheter related complications such as bowel perforation, ileus, and pseudocyst formation [12]. The incidence of shunt failure was 14% in pediatric surgeries and estimated failure of shunt was 4% to 50% might fail within the first year [13].…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study On Ventriculoperitoneal Shunt Surgery Complications In Tertiary Care Hospital

Khan¹

2022

Journal of Pharmaceutical Negative Results

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Background and Aim: Hydrocephalus is defined as enlargement in ventricles size due to the increase in cerebrospinal fluid volume. Impaired cerebrospinal fluids in terms of absorption and pathways obstruction or subarachnoid spaces are the different causes for hydrocephalus. Ventriculoperitoneal shunt is the most prevalent performed treatment modality on elective or emergency basis for hydrocephalus in neurosurgery. However, this treatment modality is apprehended due to its various complications. There is paucity of data regarding ventriculoperitoneal shunt surgery complications. The present study aimed to evaluate the ventriculoperitoneal shunt complications in a tertiary care hospital. Methodology: This prospective study was conducted on 96 hydrocephalus patients who underwent ventriculoperitoneal shunt in the Department of Neurosurgery, Lady Reading Hospital, Peshawar from January 2020 to December 2021. Hospital research and ethical committee approved the study protocol and written informed consent was obtained from each patient. Hydrocephalus patients of either gender without age discrimination who underwent first ventriculoperitoneal shunts were enrolled. Patients who underwent external ventricular drain, lumboperitoneal shunts, shunts revision, and ventriculoatrial shunts were excluded. Detailed history, clinical inspections, and full investigations such as cerebrospinal fluid, C-reactive protein (CRP), X-rays examinations, full blood count (FBC), brain CT scans and abdomen pelvis ultrasound has been carried out in all eligible patients. Post-surgery routine follow-up was scheduled one and six months after discharge. SPSS version 25 was used for data analysis. Results: Of the total 96 hydrocephalus patients, there were 63 (66%) male and 33 (34%) females. Patient’s age-wise distribution was as follows: Age< 1 year 36 (37.5%), 1-10 years 28 (29.2%), 11-20 years 22 (22.9%), 21-30 years 7 (7.3%), and 31-40 years 3 (3.1%). The incidence of ventriculoperitoneal shunt surgery complications such as shunt blockage, infection, shunt erosion, and extrusion was 44 (45.8%), 34 (35.4%), 16 (16.7%), and 9 (9.4%) respectively. The mortality rate was 3.1% due to the complications of ventriculoperitoneal shunt surgery. Brain tumors was the most prevalent cause of hydrocephalus in 37 (38.5%) followed by Post-meningitis 21 (21.9%), encephaloceles 11 (11.5%), Cerebellar hematoma 10 (10.4%), Intraventricular hemorrhage 6 (6.3%), Aqueduct stenosis 4 (4.2%), Neurocysticercosis 2 (2.1%) and others 2 (2.1%). Conclusion: Our study concluded that the most prevalent ventriculoperitoneal shunt surgery complications were shunt blockage and shunt infection. Brain tumors were the common cause of hydrocephalus followed by post-meningitis and encephaloceles. Shunt upper end is more susceptible to complications than the lower end. The overall mortality rate was 3.1%. These complications might leads to server clinical issues that results patient’s death.

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Rare complication of lumboperitoneal shunt with distal catheter migration into the inguinal hernia sac in two adults: A case report

Tanaka,

Fujiwara,

Sashida

et al. 2023

Surgical Neurology International

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Background: Despite the proven benefits of lumboperitoneal shunt (LPS) for idiopathic normal-pressure hydrocephalus, complications such as catheter migration remain a problem. Inguinal complications of the distal catheter are rare in adults, and their management is uncertain. Herein, we present two cases of distal catheter migration into the inguinal hernia sac after LPS in adults and recommend their management. Case Description: An 86-year-old man presented with inguinal swelling. In another 82-year-old man who did not show any improvement after LPS, shunt angiography revealed LPS dysfunction due to lumbar catheter occlusion and distal LPS catheter in the right inguinal hernia sac, and lumbar catheter reconstruction was performed. Both patients did not have any symptoms, except inguinal swelling, and were followed up. After 2 weeks and 4 days, the distal catheter moved into the peritoneal cavity. Conclusion: Inguinal complications due to the migration of the distal catheter into the inguinal hernia sac are rare in LPS because frequent movements of the distal catheter due to trunk rotation dislodge it from the inguinal hernia sac for a short period. Urgent surgery was not recommended because the catheter was moved in a short period and the patients did not wish to undergo hernia repair.

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Migration of distal ventriculoperitoneal shunt catheter into an inguinal hernia sac in an adult patient: a case report and literature review

Cited by 3 publications

References 8 publications

Unusual presentation of a common neurosurgical shunt procedure in an adult patient

Unusual presentation of a common neurosurgical shunt procedure in an adult patient

A Prospective Study On Ventriculoperitoneal Shunt Surgery Complications In Tertiary Care Hospital

Rare complication of lumboperitoneal shunt with distal catheter migration into the inguinal hernia sac in two adults: A case report

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