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IMAGES IN MEDICINE
Year : 2018  |  Volume : 31  |  Issue : 6  |  Page : 375

Retrograde migration and expulsion of ventriculoperitoneal shunt from the neck


Department of Neurology, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication17-Jul-2019

Correspondence Address:
Vinay Goyal
Department of Neurology, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-258X.262907


How to cite this article:
Elavarasi AM, Singh A, Goyal V. Retrograde migration and expulsion of ventriculoperitoneal shunt from the neck. Natl Med J India 2018;31:375

How to cite this URL:
Elavarasi AM, Singh A, Goyal V. Retrograde migration and expulsion of ventriculoperitoneal shunt from the neck. Natl Med J India [serial online] 2018 [cited 2019 Oct 20];31:375. Available from: http://www.nmji.in/text.asp?2018/31/6/375/262907





A 38-year-old man had a ventriculoperitoneal (VP) shunt placed for hydrocephalus due to tubercular meningitis. He had complete resolution on antitubercular treatment.

One year later, he had painless swelling at the right supraclavicular area with excoriation of the skin and a clear discharge. After 2 days, the distal end of the VP shunt was completely expelled from his neck. Clear cerebrospinal fluid was dripping from the expelled end (Fig. 1). CT head showed that the proximal end of the VP shunt was in place. To the best of our knowledge such an expulsion of the distal end of the VP shunt from the neck region has not been reported before.[1]

Various mechanisms have been proposed to explain the upward migration of the shunt. Some of these are: loose or inadequate fixation of the tubing to the pericranium, lack of a reservoir, too long a catheter, faulty technique, excessive subcutaneous undermining, etc.[2] Dominguez et al. reported the complete coiling of an Orbis Sigma valve and attributed this to the retained ‘memory’ of the shunt material within its sterile package.[3]

Conflicts of interest. None declared



 
  References Top

1.
Gatto LA, Mathias R, Tuma R, Abdalla R, de Aguiar PH. Rare complication of ventriculoperitoneal shunt: Catheter protrusion to subcutaneous tissue [Case report]. Surg Neurol Int 2016;7: S1142-S1146.  Back to cited text no. 1
    
2.
Martínez-Lage JF, Guillén-Navarro E, Almagro MJ, Felipe-Murcia M, López López-Guerrero A, Galarza M, et al. Hydrocephalus and Chiari type 1 malformation in macrocephaly-cutis marmorata telangiectatica congenita: A case-based update. Childs Nerv Syst 2010;26:13-18.  Back to cited text no. 2
    
3.
Dominguez CJ, Tyagi A, Hall G, Timothy J, Chumas PD. Sub-galeal coiling of the proximal and distal components of a ventriculo-peritoneal shunt. An unusual complication and proposed mechanism. Childs Nerv Syst 2000;16:493-5.  Back to cited text no. 3
    




 

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