Skip to main content

Advertisement

SpringerLink
Log in

Ventriculoperitoneal shunt migration into the pulmonary artery

  • Short Illustrated Review
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Ventriculoperitoneal (VP) shunting is the most common form of treatment for hydrocephalus. Complications of VP shunts may occur anywhere along their course from the cerebral ventricle to the peritoneal cavity. Rare complications such as migration of the peritoneal catheter into the stomach, gallbladder, urinary bladder, vagina, liver, bowel, colon, and diaphragm have been described in the literature.

Methods

In this review of the literature we discuss the rare but serious event of migration of the distal catheter of a ventriculoperitoneal shunt (VP shunt) into the pulmonary artery. We present an additional patient with a special emphasis on minimally invasive treatment.

Results

The patient’s postoperative course was uneventful, and a postoperative plain X-ray of the chest and abdomen confirmed appropriate placement of the new distal catheter intraperitoneally.

Conclusion

It is useful to consider alternative nonsurgical techniques for percutaneous intravascular foreign body retrieval. Many different percutaneous techniques have been described. Rare complications of percutaneous intravascular foreign body retrieval may include transient cardiac arrhythmia, fragmentation of the foreign body, or migration of the foreign body to a different location. A multidisciplinary discussion and approach is pivotal to treating this extraordinarily rare complication.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. 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. doi:10.2176/nmc.26.256

    Article  CAS  Google Scholar 

  2. 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. doi:10.1007/s001340051255

    Article  PubMed  Google Scholar 

  3. 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

    PubMed  Google Scholar 

  4. 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

    PubMed  CAS  Google Scholar 

  5. Frazier JL, Wang PP, Patel SH, Benson JE, Cameron DE, Hoon AH Jr et al (2002) Unusual migration of the distal catheter of a ventriculoperitoneal shunt into the heart: case report. Neurosurgery 51:819–822. doi:10.1097/00006123-200209000-00042

    Article  PubMed  Google Scholar 

  6. Fukamachi A, Wada H, Toyoda O, Wakao T, Kawafuchi J (1982) Migration or extrusion of shunt catheters. Acta Neurochir (Wien) 64:159–166. doi:10.1007/BF01405628

    Article  CAS  Google Scholar 

  7. 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. doi:10.1097/00006123-198812000-00017

    Article  PubMed  CAS  Google Scholar 

  8. Grosfeld JL, Cooney DR, Smith J, Campbell RL (1974) Intra-abdominal complications following ventriculoperitoneal shunt procedures. Pediatrics 54:791–796

    PubMed  CAS  Google Scholar 

  9. 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. doi:10.1016/0090-3019(96) 00052-3

    Article  PubMed  CAS  Google Scholar 

  10. Hlavin ML, Mapstone TB, Gauderer MW (1990) Small bowel obstruction secondary to incomplete removal of a ventriculoperitoneal shunt: case report. Neurosurgery 26:526–528. doi:10.1097/00006123-199003000-00024

    Article  PubMed  CAS  Google Scholar 

  11. Imamura H, Nomura M (2002) Migration of ventriculoperitoneal shunt into the heart-case report. Neurol Med Chir (Tokyo) 42:181–183. doi:10.2176/nmc.42.181

    Article  Google Scholar 

  12. 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. doi:10.1007/BF00266827

    Article  PubMed  CAS  Google Scholar 

  13. 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. doi:10.1016/j.surneu.2004.04.022

    Article  PubMed  Google Scholar 

  14. Krauss JK, Regel JP, Vach W, Orszagh M, Jüngling FD, Bohus M et al (1997) White matter lesions in patients with idiopathic normal pressure hydrocephalus and in an age-matched control group: a comparative study. Neurosurgery 40:491–495. doi:10.1097/00006123-199703000-00011

    Article  PubMed  CAS  Google Scholar 

  15. Kubo S, Takimoto H, Takakura S, Iwaisako K, Yamanaka K, Hosoi K et al (2002) Peritoneal shunt migration into the pulmonary artery—case report. Neurol Med Chir (Tokyo) 42:572–574. doi:10.2176/nmc.42.572

    Article  Google Scholar 

  16. Lourie H, Bajwa S (1985) Transdiaphragmatic migration of a ventriculoperitoneal catheter. Neurosurgery 17:324–326. doi:10.1097/00006123-198508000-00014

    Article  PubMed  CAS  Google Scholar 

  17. 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. doi:10.1007/s003810050084

    Article  PubMed  CAS  Google Scholar 

  18. McCullough DG (1985) Hydrocephalus treatment. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 2140–2150

    Google Scholar 

  19. 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. doi:10.1016/S0140-6736(06) 69811-5

    Article  PubMed  Google Scholar 

  20. 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

    PubMed  CAS  Google Scholar 

  21. 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

    PubMed  CAS  Google Scholar 

  22. Patel CD, Matloub H (1973) Vaginal perforation as a complication of ventriculoperitoneal shunt. Case report. J Neurosurg 38:761–762

    Article  PubMed  CAS  Google Scholar 

  23. Portnoy HD, Croissant PD (1973) Two unusual complications of a ventriculoperitoneal shunt. Case report. J Neurosurg 39:775–776

    Article  PubMed  CAS  Google Scholar 

  24. 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

    PubMed  CAS  Google Scholar 

  25. Taub E, Lavyne MH (1994) Thoracic complications of ventriculoperitoneal shunts: case report and review of the literature. Neurosurgery 34:181–183. doi:10.1097/00006123-199401000-00028

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany

    Elvis J. Hermann & Gerhard Marquardt

  2. Department of Neurosurgery, Klinikum Duisburg Nord, Duisburg, Germany

    Michael Zimmermann

  3. Department of Neurosurgery, Medical School Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany

    Elvis J. Hermann

Authors
  1. Elvis J. Hermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Zimmermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gerhard Marquardt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elvis J. Hermann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hermann, E.J., Zimmermann, M. & Marquardt, G. Ventriculoperitoneal shunt migration into the pulmonary artery. Acta Neurochir 151, 647–652 (2009). https://doi.org/10.1007/s00701-009-0282-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-009-0282-9

Keywords

Search

Navigation