Abstract
Introduction
Migration of the distal catheter into the heart is an extremely rare complication of ventriculoperitoneal shunt, with only 11 cases reported in literature; in only four of them, there was also the migration into the pulmonary artery. The authors report the case of a young patient with this rare complication that was managed simply converting the ventriculoperitoneal shunt into a ventriculoatrial shunt.
Discussion
The migration of the distal catheter occurred through the internal jugular vein probably as the consequence of direct damage of the vessel during tunneling. Venous flow and negative intrathoracic pressure may have gradually pulled the catheter up into the heart; the upward migration may also be encouraged by the continuous movements of the patient that was agitated in the postoperative period as the consequence of her psychiatric disorder. The authors review the literature regarding migration of distal tubing into the heart and pulmonary artery. Diagnosis and management of this complication is discussed.
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Anegawa S, Yoshida M, Kuramoto S, Ohmori Y (1986) Migration of ventriculo-peritoneal shunt into the chest. Case report. Neurol Med-Chir (Tokyo) 26:256–261
Chong JY, Kim JM, Cho DC, Kim CH (2008) Upward migration of distal ventriculoperitoneal shunt catheter into the heart: case report. J Korean Neurosurg Soc 44(3):170–173
Di Roio C, Mottolese C, Cayrel V, Artru F (2000) Respiratory distress caused by migration of ventriculoperitoneal shunt catheter into the chest cavity. Intensive Care Med 26:818
Fewel ME, Garton HJ (2004) Migration of distal ventriculoperitoneal shunt catheter into the heart. Case report and review of the literature. J Neurosurg 100:206–211
Fischer G, Goebel H, Latta E (1983) Penetration of the colon by a ventriculo-peritoneal drain resulting in an intra-cerebral abscess. Zentralbl Neurochir 44:155–160
Frazier JL, Wang PP, Patel SH, Benson JE, Cameron DE, Hoon AH Jr, Avellino AM (2002) Unusual migration of the distal catheter of a ventriculoperitoneal shunt into the heart: case report. Neurosurgery 51:819–822
Fukamachi A, Wada H, Toyoda O, Wakao T, Kawafuchi J (1982) Migration or extrusion of shunt catheters. Acta Neurochir (Wien) 64:159–166
Gaudio R, De Tommasi A, Occhiogrosso M, Vailati G (1988) Respiratory distress caused by migration of ventriculoperitoneal shunt catheter into the chest cavity: report of a case and review of the literature. Neurosurgery 23:768–769
Grosfeld JL, Cooney DR, Smith J, Campbell RL (1974) Intraabdominal complications following ventriculoperitoneal shunt procedures. Pediatrics 54:791–796
Haralampopoulos F, Iliadis H, Karniadakis S, Koutentakis D (1996) Invasion of a peritoneal catheter into the inferior vena cava: report of a unique case. Surg Neurol 46:21–22
Hermann EJ, Zimmermann M, Marquardt G (2009) Ventriculoperitoneal shunt migration into the pulmonary artery. Acta Neurochir (Wien) 151(6):647–652
Hlavin ML, Mapstone TB, Gauderer MW (1990) Small bowel obstruction secondary to incomplete removal of a ventriculoperitoneal shunt: case report. Neurosurgery 26:526–528
Imamura H, Nomura M (2002) Migration of ventriculoperitoneal shunt into the heart—case report. Neurol Med-Chir (Tokyo) 42:181–183
Kang JK, Jeun SS, Chung DS, Lee IW, Sung WH (1996) Unusual proximal migration of ventriculoperitoneal shunt into the heart. Childs Nerv Syst 12:176–179
Kim MS, Oh CW, Hur JW, Lee HK (2005) Migration of the distal catheter of a ventriculoperitoneal shunt into the heart: case report. Surg Neurol 63:185–187
Kubo S, Takimoto H, Takakura S, Iwaisako K, Yamanaka K, Hosoi K, Toyota S, Ueno M, Morisako T, Karasawa J, Yoshimine T (2002) Peritoneal shunt migration into the pulmonary artery—case report. Neurol Med-Chir (Tokyo) 42:572–574
Lourie H, Bajwa S (1985) Transdiaphragmatic migration of a ventriculoperitoneal catheter. Neurosurgery 17:324–326
Martin LM, Donaldson-Hugh ME, Cameron MM (1997) Cerebrospinal fluid hydrothorax caused by transdiaphragmatic migration of a ventriculoperitoneal catheter through the foramen of Bochdalek. Childs Nerv Syst 13:282–284
McCullough DG (1985) Hydrocephalus treatment. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 2140–2150
Mirzayan MJ, Koenig K, Bastuerk M, Krauss JK (2006) Coma due to meteorism and increased intra-abdominal pressure subsequent to ventriculoperitoneal shunt dysfunction. Lancet 368(9551):2032
Morell RC, Bell WO, Hertz GE, D’Souza V (1994) Migration of a ventriculoperitoneal shunt into the pulmonary artery. J Neurosurg Anesthesiol 6:132–134
Nishijima M, Ohyama H, Higuchi H (1980) Gastric perforation in ventriculo-peritoneal shunt—a case report (author’s transl). No Shinkei Geka 8:679–683
Patel CD, Matloub H (1973) Vaginal perforation as a complication of ventriculoperitoneal shunt. Case report. J Neurosurg 38:761–762
Portnoy HD, Croissant PD (1973) Two unusual complications of a ventriculoperitoneal shunt. Case report. J Neurosurg 39:775–776
Rizk E, Dias MS, Verbrugge J, Boop FA (2009) Intracardiac migration of a distal shunt catheter: an unusual complication of ventricular shunts. Report of 2 cases. J Neurosurg Pediatr 3(6):525–528
Schulhof LA, Worth RM, Kalsbeck JE (1975) Bowel perforation due to peritoneal shunt. A report of seven cases and a review of the literature. Surg Neurol 3:265–269
Taub E, Lavyne MH (1994) Thoracic complications of ventriculoperitoneal shunts: case report and review of the literature. Neurosurgery 34:181–183
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Ruggiero, C., Spennato, P., De Paulis, D. et al. Intracardiac migration of the distal catheter of ventriculoperitoneal shunt: a case report. Childs Nerv Syst 26, 957–962 (2010). https://doi.org/10.1007/s00381-009-1052-y
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DOI: https://doi.org/10.1007/s00381-009-1052-y