Ventriculoperitoneal shunt migration into the pulmonary artery

Abstract

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. 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. 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. 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.