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Peritoneal shunt migration into the pulmonary artery--case report
Shigeki Kubo1, Hiroshi Takimoto, Shuji Takakura
1Department of Neurosurgery, Osaka Neurological Institute, Toyonaka, Osaka, Japan. sig-kubo@momo.so-net.ne.jp
Neurologia Medico-Chirurgica
|January 7, 2003
Summary
A rare complication of ventriculoperitoneal shunting occurred when the catheter migrated to the pulmonary artery, potentially causing fatal outcomes. Regular follow-up imaging is crucial for early detection of shunt migration.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Radiology
Background:
- Hydrocephalus secondary to subarachnoid hemorrhage from vertebral artery dissection requires intervention.
- Ventriculoperitoneal shunting is a common procedure for managing hydrocephalus.
Observation:
- A patient developed neck pain one month after ventriculoperitoneal shunting.
- Chest radiography revealed migration of the peritoneal catheter end into the right pulmonary artery.
- The catheter entered the external jugular vein, suggesting intraoperative guidewire perforation.
Findings:
- Catheter migration to the pulmonary artery is an unusual and potentially lethal complication.
- Potential consequences include pulmonary infarction and cardiac arrhythmia.
- The likely cause was guidewire perforation during the initial shunting procedure.
Implications:
- This case highlights the importance of vigilant post-operative monitoring.
- Follow-up radiography is recommended to detect shunt migration.
- Awareness of this rare complication is essential for neurosurgeons and interventional radiologists.