Migration of the abdominal catheter of a ventriculoperitoneal shunt into the mouth: a rare presentation

Abstract

A 1-year-old boy with a history of exomphalos and hydrocephalus had surgeries to correct these pathologies. The ventriculopleural (VP(L)) shunt inserted for hydrocephalus was complicated by pleural effusion, for which a ventriculoperitoneal (VP) shunt was inserted on the contralateral side. He subsequently presented with protrusion of the distal VP shunt tip from the mouth due to perforation through the gastrointestinal tract. The child also had a history of peritonitis post-exomphalos repair, which may have predisposed him to this relatively uncommon shunt complication. Probable causes and risk factors of the perforation are discussed.

Keywords: foreign-body migration; in-dwelling catheters; intestinal perforation; medical sciences; post-operative complications; ventriculoperitoneal shunt.

Figure 1:

Ventriculoperitoneal shunt tip protruding periorally

Figure 2:

Abdominal X-ray showing ventriculoperitoneal shunt tip perforating the stomach and migrating up the oesophagus (black arrow)

Figure 3:

Chest X-ray showing ventriculoperitoneal shunt tip ascending the oesophagus (black arrow). Right-sided ventriculopleural shunt could be seen (white arrow)