Thoracic complications of ventriculoperitoneal shunts: case report and review of the literature.
Thoracic complications of ventriculoperitoneal shunts are rare, but potentially serious. The authors report a case of a drainage of cerebrospinal fluid into the tracheobronchial tree through a peritoneal shunt catheter that migrated into the chest. After injection of contrast material into the shunt, a plain radiograph of the chest revealed a bronchogram. The symptoms resolved after a revision of the shunt. Published case reports of this and other thoracic complications of ventriculoperitoneal shunts are comprehensively reviewed. A classification of such complications into three types is proposed as follows: intrathoracic trauma during placement of a shunt, migration of the peritoneal catheter into the chest (by either a supradiaphragmatic or a transdiaphragmatic route), and pleural effusion accompanying cerebrospinal fluid ascites. The possible mechanisms and contributing factors are discussed.
Taub
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E
Division of Neurosurgery, New York Hospital-Cornell University Medical College, New York.
Lavyne
M H
MH
D000328:Adult; D001139:Arnold-Chiari Malformation / Q000175:diagnosis / Q000601:surgery*; D001980:Bronchi / Q000601:surgery*; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation; D013595:Syringomyelia / Q000175:diagnosis / Q000601:surgery*; D017287:Ventriculoperitoneal Shunt / Q000295:instrumentation*