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Tanaka T, Fujiwara R, Sashida R, Hirokawa Y, Wakamiya T, Michiwaki Y, Shimoji K, Suehiro E, Onoda K, Yamane F, Matsuno A. Rare complication of lumboperitoneal shunt with distal catheter migration into the inguinal hernia sac in two adults: A case report. Surg Neurol Int 2023; 14:392. [PMID: 38053705 PMCID: PMC10695460 DOI: 10.25259/sni_389_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/12/2023] [Indexed: 12/07/2023] Open
Abstract
Background Despite the proven benefits of lumboperitoneal shunt (LPS) for idiopathic normal-pressure hydrocephalus, complications such as catheter migration remain a problem. Inguinal complications of the distal catheter are rare in adults, and their management is uncertain. Herein, we present two cases of distal catheter migration into the inguinal hernia sac after LPS in adults and recommend their management. Case Description An 86-year-old man presented with inguinal swelling. In another 82-year-old man who did not show any improvement after LPS, shunt angiography revealed LPS dysfunction due to lumbar catheter occlusion and distal LPS catheter in the right inguinal hernia sac, and lumbar catheter reconstruction was performed. Both patients did not have any symptoms, except inguinal swelling, and were followed up. After 2 weeks and 4 days, the distal catheter moved into the peritoneal cavity. Conclusion Inguinal complications due to the migration of the distal catheter into the inguinal hernia sac are rare in LPS because frequent movements of the distal catheter due to trunk rotation dislodge it from the inguinal hernia sac for a short period. Urgent surgery was not recommended because the catheter was moved in a short period and the patients did not wish to undergo hernia repair.
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Affiliation(s)
- Tatsuya Tanaka
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Japan
| | - Ren Fujiwara
- Department of Neurosurgery, Narita Tomisato Tokushukai Hospital, Tomisato, Japan
| | - Ryohei Sashida
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Japan
| | - Yu Hirokawa
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Japan
| | - Tomihiro Wakamiya
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Japan
| | - Yuhei Michiwaki
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Japan
| | - Kazuaki Shimoji
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Japan
| | - Eiichi Suehiro
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Japan
| | - Keisuke Onoda
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Japan
| | - Fumitaka Yamane
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Japan
| | - Akira Matsuno
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Japan
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Alkhudari A, Galal M, Wagley Z, Sabbah BN, Houdane A, Aljabr A. A case of spontaneous resolution of a scrotal ventriculoperitoneal shunt migration. Radiol Case Rep 2022; 17:3620-3623. [PMID: 35923335 PMCID: PMC9340143 DOI: 10.1016/j.radcr.2022.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 12/02/2022] Open
Abstract
Ventriculoperitoneal (VP) shunt catheter migration remains a rare but documented complication seen in one in 1000 patients who receive a VP shunt. Migration of the VP shunt into the scrotum is even more uncommon and requires surgical treatment. We report a unique case of a 6-month-old preterm male who developed right scrotal migration of his VP shunt. However, the tip of the VP shunt spontaneously reduced to its normal position, and repeated imaging months later showed no recurrence.
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