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Updated: Aug 15, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Scrotal migration of a ventriculo-peritoneal shunt: report of a case
1Department of Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan R.O.C.
Insights
A hydrocele in an infant resolved after repositioning a ventriculo-peritoneal shunt tip that migrated to the scrotum. This migration is theorized to be caused by cerebrospinal fluid flow into the processus vaginalis.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Urology
Background:
- Ventriculo-peritoneal (VP) shunts are used to treat hydrocephalus in infants.
- Shunt complications can include migration and infection.
- Hydrocele is a potential complication following VP shunt placement.
Observation:
- A seven-month-old infant developed a hydrocele post-VP shunt surgery.
- The shunt tip was located in the scrotum, confirmed by physical exam and imaging.
- Initial shunt repositioning did not resolve the hydrocele as the tip migrated back.
Findings:
- Cerebrospinal fluid (CSF) flow into a patent processus vaginalis may create a trough effect, drawing the mobile shunt tip.
- Inguinal herniotomy and shunt tip reduction successfully resolved the hydrocele.
- This suggests a specific mechanism for shunt migration in this anatomical context.
Implications:
- Understanding shunt migration mechanisms is crucial for preventing complications.
- Surgical strategies may need to account for potential shunt migration into the processus vaginalis.
- This case highlights the importance of anatomical considerations in pediatric shunt surgery.
Abstract:
A seven-month-old male infant developed a hydrocele four weeks after the surgical insertion of a ventriculo-peritoneal shunt. The shunt tip in the scrotum was palpable, visible on transillumination, and evident on abdominal X ray. The hydrocele persisted after the surgical repositioning of the shunt tip via a reopening of the abdominal wound. The shunt tip returned to the scrotum one week later, supporting the theory that a flow of cerebrospinal fluid into the patent processus vaginalis creates a trough effect, thus drawing the mobile shunt tip into the center of the trough. After an inguinal herniotomy and the reduction of the shunt tip, the hydrocele subsided.
