Migration of the distal end of a ventriculoperitoneal shunt into the abdominal wall in an obese patient: case report.
A 64-year-old obese woman underwent ventriculoperitoneal shunting for hydrocephalus associated with subarachnoid hemorrhage. On the 10th postoperative day, the distal end of the peritoneal catheter migrated into the abdominal wall and she developed a cyst filled with cerebrospinal fluid around the migrated catheter. The distal end of the catheter was surgically repositioned. We attribute the migration to increased intra-abdominal pressure due to obesity, the use of a low friction hydrogel-processed peritoneal catheter, and the presence of a large dead space around the catheter. The laparotomy must be closed meticulously to prevent this type of migration.
Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan. nakahara19@hotmail.com
Kuniaki
K
Nakahara
Satoru
S
Shimizu
Hidehiro
H
Oka
Satoshi
S
Utsuki
Hideo
H
Iida
Kiyotaka
K
Fujii
D000007:Abdominal Injuries / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D034861:Abdominal Wall / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology; D003560:Cysts / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005548:Foreign-Body Migration / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D017276:Friction; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate / Q000009:adverse effects; D007813:Laparotomy / Q000009:adverse effects; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011312:Pressure / Q000009:adverse effects; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
D020136:Hydrogel, Polyethylene Glycol Dimethacrylate