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Updated: Aug 20, 2025
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Transvaginal Migration of Ventriculoperitoneal Shunts in Children: Review of Literature
Shashikanth R Ambati1, Suzanne Barry1, Adamo A Matthew2
1Department of Pediatric Critical Care, Albany Medical Center, Albany, New York, United States.
Insights
Vaginal migration of ventriculo-peritoneal shunts is a rare complication in children. Early identification by healthcare providers is crucial to prevent serious outcomes like ventriculitis and prolonged hospitalization.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Medical Device Complications
Background:
- Ventriculo-peritoneal shunts are standard treatment for hydrocephalus.
- Distal shunt migration is a known complication, with vaginal migration being rare in pediatric cases.
- Prompt recognition and management are vital to minimize patient morbidity.
Purpose of the Study:
- To review and synthesize existing literature on vaginal migration of ventriculo-peritoneal shunts in children.
- To aid healthcare providers in early identification and management of this complication.
- To reduce associated morbidity and mortality in pediatric patients.
Main Methods:
- Systematic literature review of cases of vaginal shunt migration in patients under 18.
- Searches conducted across PubMed, Google Scholar, Web of Science, and Cochrane Library.
- Inclusion criteria applied to 93 initially identified articles, with 11 meeting eligibility.
Main Results:
- Previous abdominal surgeries and shunt revisions were identified as consistent risk factors.
- No specific catheter placement or management strategies were found to prevent this complication.
- Ventriculitis, requiring shunt removal, and prolonged hospitalization were major identified consequences.
Conclusions:
- Awareness of rare ventriculo-peritoneal shunt vaginal migration is critical for all healthcare providers, especially emergency personnel.
- Early detection is key to limiting severe consequences such as infection and extended hospital stays.
- Further research may explore preventative strategies, though none were identified in this review.
Abstract:
Ventriculo-peritoneal shunt placement is the most commonly performed procedure for the treatment of hydrocephalus. The complication of migration of the distal ventriculo-peritoneal shunt is one of the many complications that occur after ventriculo-peritoneal shunt placement. The migration of the ventriculo-peritoneal shunt through the vagina is infrequently reported in children. The aim of this review is to help all the providers caring for children with ventriculo-peritoneal shunts to identify issues early when encountered with this complication and thus limit morbidity and mortality. We reviewed all cases of migration of ventriculo-peritoneal shunt through the vagina in children less than 18 years of age that were published in the literature using PubMed, Google Scholar, Web of Science, and Cochrane Library. A total of 11 articles met the eligibility criteria and were included in this review among the 93 articles obtained with title and abstract screening. Previous non-shunt-related abdominal operations and shunt revisions are consistent risk factors in all cases. We did not recognize specific approaches to catheter placement or management that could have prevented this complication. Ventriculitis necessitating shunt removal and therapies requiring additional procedures and prolonged hospitalization are the major consequences identified. Awareness of this unusual complication is very important among health care providers such as emergency care health providers who are likely to be the first to encounter these children on initial presentation.
