Dr. Shrivimika Rao
Intrathoracic migration of ventriculoperitoneal shunt is a rare complication and usually complicated with pneumonia or cerebrospinal fluid hydrothorax, which leads to diagnosis and early interventions. Very rarely patient remains asymptomatic [1]. Here is a case report of a 6-year-old boy with a rare asymptomatic intrathoracic migration of ventriculoperitoneal shunt. The cerebrospinal fluid shunt is a device implanted surgically in a CSF containing space to divert the excess fluid in a controlled manner to any distal compartment that can absorb CSF such as the pleura, atrium and peritoneum, being the later most favored. The shunting system is composed of a shunt valve, distal catheter, proximal catheter (ventricular catheter) and some accessories such as connectors and reservoirs (shunt chamber). A Shunt is known to be used as a treatment for many neurosurgical cases including hydrocephalus; it is a very effective way to reduce cerebrospinal fluid accumulation within brain ventricles which help save the patient from serious brain damage that can lead to mental retardation in pediatrics age group. Complications of VP shunts are common and reach up to 47%. Shunts can carry the risk for infections such as meningitis, ventriculitis and sepsis, leakage of CSF fluid at puncture site, rapid shunting of the fluid can lead to ventricular collapse, bleeding and abdominal complications such as volvulus, pseudo cyst and extrusion of the tube through viscus, heart, vagina and scrotum [2]. In this case report we are presenting a rare complication of the cerebral shunt; it is a case of a 4 years old female patient in which the distal end of the shunt has migrated and extruded through the anus. Case Presentation a 4 years old female, a known case of encephalocele for which a Shunt was placed at the age of 1 year, was brought to the emergency department with a small tube coming out of her anus that was found accidentally, the patient was asymptomatic. The diagnosis was perforated anus due to VP Shunt.
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