Rare complication of ventriculoperitoneal shunt: Ectopic distal catheter in a Grynfeltt hernia - case report

Ventriculoperitoneal shunts (VPSs) insertion is the most common used intervention in cases of hydrocephalus. The main postoperative complications are infections and catheter obstructions. Although the literature has well-documented cases describing migration of the distal catheter, this rare presentation can become more confusing when occurring in conjunction with some unusual preexistent morbidity in the patient, as a Grynfeltt hernia.

This study reports a rare case of a VPS postoperative migration, in which the distal catheter exits the abdominal cavity through a Grynfeltt hernia. This condition was not discovered until the catheter fistulated through the overlying skin. The Grynfeltt hernia is the most uncommon among the lumbar ones and it's asymptomatic in the majority of the cases, being hardly diagnosed.

The unusualness of the reported case deserves furthermore discussion to properly evaluate these underlying mechanisms of catheter migration.