Penetration of a divided cystoperitoneal shunt catheter into the transverse colon inducing acute mastitis
Kentaro Shimodaira1, Yasuyuki Miyakura2, Ai Sadatomo1
1Department of Surgery, Jichi Medical University, Tochigi, Japan.
We report a rare case of acute mastitis caused by enteric organisms passing through a cystoperitoneal shunt catheter, which had penetrated into the colon. The patient is a 56-year-old woman who underwent shunt placement for cyst formation after surgery for meningioma at the age of 29. After 26 years, she suffered from a brain abscess and an attempt was made to surgically remove the indwelling catheter. Only part of the catheter could be removed, leaving a divided and ligated catheter in situ. A year later, she described right-breast pain. CT showed that the catheter had migrated into the colon, followed by colonoscopy confirming that the catheter had indeed penetrated the colon. The breast to the abdomen segment of the catheter was exteriorized through the right-anterior chest wall without laparotomy. A patient who presents with acute mastitis and has previously undergone shunt surgery should have a careful assessment of the entire catheter.
We report a rare case of acute mastitis caused by enteric organisms passing through a cystoperitoneal shunt catheter, which had penetrated into the colon. The patient is a 56-year-old woman who underwent shunt placement for cyst formation after surgery for meningioma at the age of 29. After 26 years, she suffered from a brain abscess and an attempt was made to surgically remove the indwelling catheter. Only part of the catheter could be removed, leaving a divided and ligated catheter in situ. A year later, she described right-breast pain. CT showed that the catheter had migrated into the colon, followed by colonoscopy confirming that the catheter had indeed penetrated the colon. The breast to the abdomen segment of the catheter was exteriorized through the right-anterior chest wall without laparotomy. A patient who presents with acute mastitis and has previously undergone shunt surgery should have a careful assessment of the entire catheter.
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