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Spontaneous regression of migrated ventriculoperitoneal shunt catheter from scrotum to peritoneum: a case-based review

  • Case-based Review
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Abstract

Objective

The incidence of scrotal migration of a ventriculoperitoneal shunt (VPS) catheter is rare and may lead to life-threatening visceral complications. Management requires prompt removal of the migrated portion of the shunt and closure of the scrotal sac. We report an interesting case of a young child who presented with asymptomatic unilateral swelling of his scrotum secondary to a migrated VPS catheter. A repeat X-ray prior to his surgery to remove the migrated catheter showed that the entire length of the distal VPS catheter was back in the peritoneal cavity. In view of this unusual phenomenon, the case is discussed in corroboration with published literature.

Methods and results

A systematic search of publications in the English language is performed in PubMed and Google Scholar. Our findings show that there are 49 reported cases (including our patient) of scrotal migration of shunt catheters in patients less than 18 years old. There is only 1 other case of spontaneous resolution of shunt catheter from the scrotum. Favoured management of choice is repositioning the distal shunt catheter back into the peritoneal cavity and herniotomy in the same setting, if possible. Overall, the literature suggests this is a shunt-related complication that has a good prognosis if intervention is timely.

Conclusion

Scrotal migration of a VPS catheter is a rare but potentially life-threatening complication in children. Our case report highlights the role of updated preoperative imaging and the need for consistent long-term shunt surveillance in children.

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All data generated or analysed during this study are included in this published article.

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Funding

We report no funding, financial support, or industrial affiliations received for the writing of this article.

Author information

Authors and Affiliations

  1. Neurosurgical Service, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore

    Yilong Wu, Lee Ping Ng & Sharon Y. Y. Low

  2. Department of Paediatric Surgery, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore

    Yong Chen

  3. Department of Neurosurgery, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Sharon Y. Y. Low

  4. SingHealth Duke-NUS Neuroscience Academic Clinical Program, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Sharon Y. Y. Low

  5. SingHealth Duke-NUS Paediatrics Academic Clinical Program, 100 Bukit Timah Road, Singapore, 229899, Singapore

    Sharon Y. Y. Low

Authors
  1. Yilong Wu
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  2. Yong Chen
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  3. Lee Ping Ng
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  4. Sharon Y. Y. Low
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Contributions

All authors have read and approved the manuscript. Conceptualization: YW and SYYL. Data curation: YC, LPN and SYYL. Formal analysis: YC and SYYL. Investigation: YW, LPN, SYYL. Methodology: SYYL. Project administration: YW, YC and LPN. Resources: SYYL. Validation: SYYL. Writing – original draft: YW, SYYL. Writing – review & editing: SYYL.

Corresponding author

Correspondence to Sharon Y. Y. Low.

Ethics declarations

Ethics approval and consent to participate

Ethics approval is provided by the hospital ethics review board (reference: SingHealth CIRB 2020/2416). The participants and/or their legal guardians signed a written consent for this study.

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The consent to publish has been included as part of the study consent.

Conflict of interest

The authors declare no competing interests.

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The authors certify that this manuscript is a unique submission and is not being considered for publication, in part or in full, with any other source in any medium. All authors made substantial contributions to the manuscript and approved its final version. 

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Wu, Y., Chen, Y., Ng, L.P. et al. Spontaneous regression of migrated ventriculoperitoneal shunt catheter from scrotum to peritoneum: a case-based review. Childs Nerv Syst 40, 19–25 (2024). https://doi.org/10.1007/s00381-023-06192-9

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  • DOI: https://doi.org/10.1007/s00381-023-06192-9

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