title: Peritoneal shunt migration into the pulmonary artery--case report.
abstract: A 48-year-old man underwent ventriculoperitoneal shunting for hydrocephalus secondary to subarachnoid hemorrhage due to left vertebral artery dissection, which had been successfully treated by trapping. The peritoneal catheter was correctly positioned via a right upper abdominal incision, and symptoms related to the hydrocephalus disappeared. One month later, the patient began to complain of pain on the right side of the neck. Chest radiography revealed that the peritoneal end of the catheter had migrated into the right pulmonary artery. The catheter route was explored through a small neck incision, and was found to enter the external jugular vein. The catheter was extracted and repositioned into the peritoneum. This type of shunt migration is quite unusual, but could be lethal by causing pulmonary infarction or arrhythmia. The catheter had probably entered the external jugular vein through a perforation caused by the shunt guide during the ventriculoperitoneal shunt operation. Follow-up radiography should be scheduled to detect such a complication.
authors.affiliation: Department of Neurosurgery, Osaka Neurological Institute, Toyonaka, Osaka, Japan. sig-kubo@momo.so-net.ne.jp
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kubo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takimoto
authors.forename: Shuji
authors.initials: S
authors.lastname: Takakura
authors.forename: Kousuke
authors.initials: K
authors.lastname: Iwaisako
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Kazuki
authors.initials: K
authors.lastname: Hosoi
authors.forename: Shingo
authors.initials: S
authors.lastname: Toyota
authors.forename: Masato
authors.initials: M
authors.lastname: Ueno
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Morisako
authors.forename: Jun
authors.initials: J
authors.lastname: Karasawa
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yoshimine
mesh_terms: D005548:Foreign-Body Migration / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010536:Peritoneovenous Shunt / Q000009:adverse effects*; D011651:Pulmonary Artery / Q000293:injuries* / Q000601:surgery