title: Ventriculomammary shunt: an unusual ventriculoperitoneal shunt complication.
abstract: Ventriculoperitoneal (VP) shunt malfunctions are common and can result in significant consequences for patients. Despite the prevalence of breast augmentation surgery and breast surgery for other pathologies, few breast related VP shunt complications have been reported. A 54-year-old woman with hydrocephalus post-subarachnoid hemorrhage returned 1 month after VP shunt placement complaining of painful unilateral breast enlargement. After investigation, it was determined that the distal VP shunt catheter had migrated from the peritoneal cavity into the breast and wrapped around her breast implant. The breast enlargement was the result of cerebrospinal fluid retention. We detail this unusual case and review all breast related VP shunt complications reported in the literature. To avoid breast related complications related to VP shunt procedures, it is important to illicit pre-procedural history regarding breast implants, evade indwelling implants during catheter tunneling and carefully securing the abdominal catheter to prevent retrograde catheter migration to the breast.
authors.affiliation: University of Miami Miller School of Medicine, Department of Neurological Surgery, 1095 NW 14th Terrace (D4-6), Miami, FL 33136, USA.
authors.forename: Nauman S
authors.initials: NS
authors.lastname: Chaudhry
authors.affiliation: University of Miami Miller School of Medicine, Department of Neurological Surgery, 1095 NW 14th Terrace (D4-6), Miami, FL 33136, USA.
authors.forename: Jeremiah N
authors.initials: JN
authors.lastname: Johnson
authors.affiliation: University of Miami Miller School of Medicine, Department of Neurological Surgery, 1095 NW 14th Terrace (D4-6), Miami, FL 33136, USA. Electronic address: jmorcos@med.miami.edu.
authors.forename: Jacques J
authors.initials: JJ
authors.lastname: Morcos
mesh_terms: D001940:Breast / Q000002:abnormalities / Q000293:injuries*; D018427:Breast Implants / Q000009:adverse effects; D004868:Equipment Failure; D005260:Female; D005548:Foreign-Body Migration; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D006984:Hypertrophy; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010529:Peritoneal Cavity; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000601:surgery; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
keywords: Breast; Cerebrospinal fluid; Cerebrospinal fluid effusion; Equipment failure; Shunt malfunction; Ventriculoperitoneal shunt