Migration of Ventriculoperitoneal Shunt Catheter into the Scrotum: A Case Report and Literature Review

Abstract

Introduction: The ventriculoperitoneal shunt is the most widely used surgical procedure for the treatment of hydrocephalus. It is associated with numerous mechanical complications, including distal catheter migration. Case report: We present a case in which the peritoneal catheter migrated into the scrotum. The patient was admitted with asymmetric scrotal swelling and, during hospitalization, developed shunt dysfunction and infection. The shunt was withdrawn and treatment was initiated for infection. At the end of treatment, a new shunt was implanted and bilateral hernioplasty was performed by the pediatric surgery team. At follow-up, there was adequate head circumference growth and no testicular abnormalities. Discussion: The procesus vaginalis is formed from the evagination of the peritoneum through the inguinal canal, leading to the descent of the testis during the embryonic period. The patency of this structure is the predisposing anatomical condition for the occurrence of inguinal hernia and for the migration of the shunt catheter into the scrotum. This condition is present in up to 80% of newborns and 60% of 1-year-old infants. The migration of the catheter commonly occurs until 12 months after surgery, typically on the right side. Conclusion: The presence of scrotal swelling in a patient with ventriculoperitoneal shunt should warrant the investigation of catheter migration.