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Case Reports
. 2015 Jan;6(1):97-9.
doi: 10.4103/0976-3147.143212.

Vaginal extrusion of a ventriculo-peritoneal shunt catheter in an adult

Christopher M Bonfield  1 , Gregory M Weiner  1 , Megan S Bradley  2 , Johnathan A Engh  1
Affiliations
Case Reports

Vaginal extrusion of a ventriculo-peritoneal shunt catheter in an adult

Christopher M Bonfield et al. J Neurosci Rural Pract. 2015 Jan.

Abstract

Ventriculo-peritoneal shunts (VPS) are commonly used in the treatment of various neurosurgical conditions, including hydrocephalus and pseudotumor cerebri. We report only the second case of vaginal extrusion of a VPS catheter in an adult, and the first case with a modern VPS silastic peritoneal catheter. A 45-year-old female with a history of VPS for pseudotumor cerebri, Behcet's syndrome, and hysterectomy presented to our institution with the chief complaint of tubing protruding from her vagina after urination. On gynecologic examination, the patient was found to have approximately 15 cm of VPS catheter protruding from her vaginal apex. A computed tomography scan of the abdomen and shunt X-ray series demonstrated no breaks in the tubing, but also confirmed the finding of the VPS catheter extruding through the vaginal cuff into the vagina. The patient had the VPS removed and an external ventricular drain was placed for temporary cerebrospinal fluid diversion. Ventricular catheter cultures were positive for diphtheroids. After an appropriate course of antibiotics, a contralateral ventriculo-pleural shunt was placed one week later. Although vary rare, vaginal extrusion can occur in adults, even with modern VPS catheters.

Keywords: Adult female; hydrocephalus; vaginal extrusion; ventriculo-peritoneal shunt.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
AP X-ray illustrating the distal VPS catheter in the peritoneum
Figure 2
Figure 2
AP X-ray illustrating the VPS catheter coursing through the pelvis and out the vagina
See this image and copyright information in PMC

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