Migration of ventriculoperitoneal shunt into the heart--case report.
A 76-year-old man underwent ventriculoperitoneal shunting for hydrocephalus after subarachnoid hemorrhage. Eighteen days after the shunt operation, fluoroscopy revealed the peritoneal catheter in the heart. Three-dimensional computed tomography demonstrated penetration of the catheter into the internal jugular vein. Under local anesthesia, part of the peritoneal catheter was pulled out through the cervical incision and cut off. The ends of the peritoneal catheter were connected so that the distal end was settled in the right atrium of the heart under fluoroscopic visualization. The migration of the peritoneal catheter into the heart presumably occurred because the subcutaneous wire guide of the shunt catheter perforated the internal jugular vein and the catheter was drawn into the heart through the internal jugular vein by the negative pressure of the vein and thoracic cavity.
Imamura
Hiroyuki
H
Department of Neurosurgery, Keiwakai Ebetsu Hospital, Ebetsu, Hokkaido.
Nomura
Mikio
M
D000368:Aged; D005548:Foreign-Body Migration / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology*; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D021621:Imaging, Three-Dimensional; D007601:Jugular Veins / Q000293:injuries; D008297:Male; D011860:Radiography, Abdominal; D013902:Radiography, Thoracic; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*; D014950:Wounds, Penetrating / Q000209:etiology