title: Intracardiac migration of the distal catheter of ventriculoperitoneal shunt: a case report.
abstract: BACKGROUND
  Migration of the distal catheter into the heart is an extremely rare complication of ventriculoperitoneal shunt, with only 11 cases reported in literature; in only four of them, there was also the migration into the pulmonary artery. The authors report the case of a young patient with this rare complication that was managed simply converting the ventriculoperitoneal shunt into a ventriculoatrial shunt.
  
  
  CONCLUSIONS
  The migration of the distal catheter occurred through the internal jugular vein probably as the consequence of direct damage of the vessel during tunneling. Venous flow and negative intrathoracic pressure may have gradually pulled the catheter up into the heart; the upward migration may also be encouraged by the continuous movements of the patient that was agitated in the postoperative period as the consequence of her psychiatric disorder. The authors review the literature regarding migration of distal tubing into the heart and pulmonary artery. Diagnosis and management of this complication is discussed.
authors.affiliation: Department of Neurosurgery, Santobono-Pausilipon Pediatric Hospital, Via Mario Fiore, Naples, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ruggiero
authors.forename: Pietro
authors.initials: P
authors.lastname: Spennato
authors.forename: Danilo
authors.initials: D
authors.lastname: De Paulis
authors.forename: Fernando
authors.initials: F
authors.lastname: Aliberti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cinalli
mesh_terms: D000293:Adolescent; D002404:Catheterization / Q000009:adverse effects*; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000601:surgery*; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007601:Jugular Veins / Q000473:pathology; D008279:Magnetic Resonance Imaging; D010529:Peritoneal Cavity / Q000000981:diagnostic imaging; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*