J Korean Neurosurg Soc.  1999 Nov;28(11):1649-1652.

Two Unusual Complications of Ventriculoperitoneal Shunts

• Cho SW
• Kim BT
• Bae HG
• Chang JC
• Shin WH
• Choi SK
• Byun BJ

Abstract

The authors report two unusual complications of ventriculoperitoneal(VP) shunt, fractured ventricular catheter and the development of a huge cyst in breast. One patient, a 2-year-old male with a history of VP shunt operation due to bacterial meningitis two years ago, presented with a drowsy consciousness and gait disturbance after trivial head injury. When shaving the scalp for the shunt revision, small dimpling site which corresponded with the head injury site, was found. On the operative field, the ventricular catheter was found to be fractured at the valve connector. The other patient, a 24-year-old female who had undergone VP shunt due to tuberculous meningitis 2 months after a laparotomy 3 years ago, presented with a progressive enlargement of the right breast 2 months prior to admission. Radiologically, the breast appeared as a cystic mass containing the shunt catheter tip. The patient underwent ventriculoatrial shunt due to the repeated extraperitoneal migration of peritoneal catheter which resulted from the intraperitoneal adhesion. Not only an intense intraperitoneal adhesion but also trivial head injury may have caused the shunt failure. Precise history taking and physical examination are important to detect the cause of shunt failure. The possible mechanisms of the shunt failures are discussed.

Keyword

Shunt complication; Fractured ventricular catheter; Breast cyst; Extraperitoneal migration; Intraperitoneal adhesion

MeSH Terms

Breast
Breast Cyst
Catheters
Child, Preschool
Consciousness
Craniocerebral Trauma
Female
Gait
Humans
Laparotomy
Male
Meningitis, Bacterial
Physical Examination
Scalp
Tuberculosis, Meningeal
Ventriculoperitoneal Shunt*
Young Adult