Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 22;41(1):239.
doi: 10.1007/s00381-025-06898-y.

Free intraabdominal catheter management post-VP shunt disconnection in pediatric patients: systematic review

Nazeer Aboud  1 , Lydia Karamani  1 , Sergio Alexander Calero Martinez  2
Affiliations

Free intraabdominal catheter management post-VP shunt disconnection in pediatric patients: systematic review

Nazeer Aboud et al. Childs Nerv Syst. .

Abstract

Ventriculoperitoneal (VP) shunting is the standard treatment for pediatric hydrocephalus but carries a high complication rate, including mechanical failure. Distal catheter disconnection and intraabdominal migration present a unique clinical dilemma: whether to retrieve or observe the retained catheter. This systematic review evaluates reported management strategies and outcomes associated with free intraabdominal catheter fragments post-VP shunt disconnection in pediatric patients. A comprehensive literature search was conducted across PubMed, Ovid, Scopus, Embase, and Google Scholar using predefined terms. A total of 4721 unique records were screened; 31 full texts were reviewed, and 11 articles met inclusion criteria. Eligible studies involved pediatric patients with disconnected VP shunts and retained peritoneal catheters, with management details and clinical outcomes. Data extraction and NIH-based quality assessment were independently performed by two reviewers. The final analysis included 11 studies (six case series, five case reports) involving 36 patients. Laparoscopic retrieval was the predominant technique (in 10 of 11 studies), often enabling concurrent catheter replacement. Outcomes were consistently favorable, with no major complications and minimal postoperative morbidity. One study required conversion to laparotomy due to visceral adhesion. Conservative management was rarely employed and not supported by outcome data. Quality assessment rated most studies as good. Free intraabdominal VP shunt catheters in pediatric patients should be retrieved when safely feasible. Laparoscopic management appears highly effective and low risk. Despite limited high-level evidence, the literature supports early elective removal to prevent delayed complications.

Keywords: Catheter disconnection; Laparoscopy; Pediatric hydrocephalus; Shunt complications; Systematic review; Ventriculoperitoneal shunt.

PubMed Disclaimer

Conflict of interest statement

Declarations. This is a systematic review, so neither ethics committee nor ethical approval was required. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow chart The flowchart describes the process for the systematic review following the PRISMA convention
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Fowler JB, De Jesus O, Mesfin FB (2025) Ventriculoperitoneal shunt. In: StatPearls. Treasure Island (FL): StatPearls Publishing. Available from: http://www.ncbi.nlm.nih.gov/books/NBK459351/. Accessed 02.01.2025 - PubMed
    1. Kahle KT, Kulkarni AV, Limbrick DD Jr, Warf BC (2016) Hydrocephalus in children. Lancet 387(10020):788–799 - PubMed
    1. Stone JJ, Walker CT, Jacobson M, Phillips V, Silberstein HJ (2013) Revision rate of pediatric ventriculoperitoneal shunts after 15 years. J Neurosurg Pediatr 11(1):15–19 - PubMed
    1. Zahedi S, Hudson M, Jin X et al (2021) Investigation of ventriculoperitoneal shunt disconnection for hydrocephalus treatment. J Neurosurg Pediatr 27(2):125–130 - PMC - PubMed
    1. Yang X, Yang C, Zhang Y (2022) Case report: Ventriculoperitoneal shunt disconnection resulting in migration of the distal catheter entirely into the abdominal cavity due to seizure. Front Surg 9:1012720 - PMC - PubMed

Publication types

LinkOut - more resources