Protrusion of a peritoneal catheter through the umblicus: an unusual complication of a ventriculoperitoneal shunt

Wani, Abrar Ahad; Ramzan, Altaf; Wani, Mohd Yaqoob

doi:10.1007/s003830100608

Cited by 35 publications

(10 citation statements)

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“…The review of literature revealed several reports regarding extrusion or abnormal migration of distal end of shunt. [ 4 5 6 7 8 9 10 ] Although most common type of migration is within the peritoneum but extrusion through anus, vagina, urethra, umbilicus, into congenital inguinal hernial sac, through anterior abdominal, chest, or from cervical region have also been occasionally reported. [ 1 4 5 6 7 8 9 10 ] The other common extraperitoneal sites are migration into thorax through the diaphragm resulting in CSF hydrothorax.…”

Section: Discussionmentioning

confidence: 99%

Abnormal migration and extrusion of abdominal end of ventriculoperitoneal shunt: An experience of eight cases

et al. 2018

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Background:Ventriculoperitoneal (VP) shunt is commonly used in the treatment of hydrocephalus. Migration and extrusion of the distal end of the VP shunt are relatively rarely occurring complications.Aim:To retrospectively analyze patients with extrusion of the abdominal end of ventriculoperitoneal shunts and evaluate the possible etiology and outcome.Settings and Design:All patients presenting with extrusion of lower end of the shunt were included. The variables collected were age, sex, site of extrusion, time duration of extrusion, presence of local infection, meningitis, shunt dependency, and treatment received. Contrast-enhanced computed tomography of brain was carried out in all patients to rule out retrograde migration of infection in the cranial cavity.Materials and Methods:Eight patients of abnormal migration and extrusion of lower end of VP shunt were included.Results:The distal end of VP shunt was extruded from the anus (n = 3), vagina (n = 2), and anterior abdominal wall (n = 3). In five of these patients, shunt catheter was draining cerebrospinal fluid (CSF), the children were afebrile and CSF was sterile. In three children with extrusion of the shunt through the abdominal wall, the shunt tract was infected. Two of these patients had abscess in the shunt tract, which required incision and drainage. Both these patients had meningitis with a growth of Streptococcus species from CSF. Seven patients required further CSF diversion such as endoscopic third ventriculostomy (n = 3) or placement of VP shunt (n = 4).Conclusion:Distal tip migration of VP shunt may prove to have potentially serious complications such as meningitis. A prompt and aggressive protocol of management is recommended.

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Section: Discussionmentioning

confidence: 99%

Abnormal migration and extrusion of abdominal end of ventriculoperitoneal shunt: An experience of eight cases

et al. 2018

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“…In the paediatric literature Wani et al . presented a single case of an 18 month old with congenital hydrocephalus presenting with fever some 6 months post VP shunt insertion [3]. In this case due to the small size of the patient, the distal catheter could easily be palpated at the umbilicus making the diagnosis obvious and easily confirmed with bedside ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Repeated cannulation of umbilical hernia with Ventriculoperiotoneal shunt catheter

Laidlaw

Little

2014

Journal of Surgical Case Reports

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Ventriculoperitoneal (VP) shunts are commonly used to manage hydrocephalus in both adult and paediatric populations. Whilst infection remains by far the most common complication leading to shunt revision other causes need to be considered. Our case report examines a 62-year-old female who presents for operative management of a Choroid Plexus Papilloma. Post-operatively she develops hydrocephalus and is managed with a VP shunt. Interestingly the distal end of the catheter cannulated an unknown umbilical hernia twice creating diagnostic dilemma. Issues around shunt insertion in the morbidly obese population and the basic science behind cerebrospinal fluid reabsorption are explored. Although this is a rare complication it should be considered in any post-operative shunt patient is slow to recover particularly if they are obese.

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“…A thorough search of the medical literature reveals a report of 12 such cases [1,5,6,7,8,9,10] of which catheter protrusion through the umbilicus was seen in 3 [1, 8, 9]. Congenital hydrocephalus remains a common cause for CSF diversion surgery, especially among pediatric patients [1, 5, 7, 9].…”

Section: Discussionmentioning

confidence: 99%

“…Congenital hydrocephalus remains a common cause for CSF diversion surgery, especially among pediatric patients [1, 5, 7, 9]. Numerous reports have tried to explain the pathogenesis of such a complication, which includes anatomical weakness [1], umbilical abscess [8], persistent umbilical vein [6], perivisceritis [6] or persistent urachal remnant [10].…”

Section: Discussionmentioning

confidence: 99%

CSF Fistula through the Umbilicus following a Shunt Surgery: A Case Report and Literature Review

2007

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Background: Ventriculoperitoneal shunting is among the commonest neurosurgical operations. Shunt catheters within the peritoneal cavity have migrated through and perforated almost all the intra-abdominal hollow viscera. Case Description: A unique case of an infant is presented, in whom CSF leaked via a fistulous opening through the umbilicus. The embryological aspect of this anomalous communication is described, along with all the 7 cases previously reported with their pathophysiological causes. Conclusions: The CSF fistula through the umbilicus may be due to varying pathological causes. The present paper describes an altogether new pathological cause behind such a complication, with a re-visit to all other described causes. The present description of a patent intercoelomic communication, an embryological remnant, puts a new light on this 3-decade-old complication.

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Protrusion of a peritoneal catheter through the umblicus: an unusual complication of a ventriculoperitoneal shunt

Abstract: Protrusion of a ventriculoperitoneal (VP) shunt through the umblicus is one of the rare complications of shunt insertion reported in the medical literature. One such case is presented here in a child in whom a VP shunt had been placed for congenital hydrocephalus.

Cited by 35 publications

References 0 publications

Abnormal migration and extrusion of abdominal end of ventriculoperitoneal shunt: An experience of eight cases

Abnormal migration and extrusion of abdominal end of ventriculoperitoneal shunt: An experience of eight cases

Repeated cannulation of umbilical hernia with Ventriculoperiotoneal shunt catheter

CSF Fistula through the Umbilicus following a Shunt Surgery: A Case Report and Literature Review

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