title: Vesical calculi formation on the slit valves of a migrated distal end of ventriculoperitoneal shunt.
abstract: Various complications of distal end of the ventriculoperitoneal (VP) shunt have been described in the literature. We present, here, an extremely rare and potentially severe complication of vesical calculi formation on the slit valves of distal end of VP shunt which erosively migrated into the urinary bladder. Suprapubic cystolithotomy performed, peritoneal end of the tube found to be eroding and entering into the bladder with two calculi firmly stuck to slit valves in the distal end of the tubing were removed. Shunt was functional, therefore, it was pulled out and repositioned on the superior aspect of the liver; the urinary bladder was repaired. Patient did well postoperatively. This complication was revealed 1.5 years after the shunt was implanted. Although there were symptoms of dysuria and dribbling of urine of short duration, the patient did not show obvious peritoneal signs; suggesting that, penetration of a VP shunt into the urinary bladder can remain asymptomatic for a long period of time, disclosed late and can lead to considerable morbidity. Careful follow-up is important and management should be individualized.
authors.affiliation: Department of Pediatrics Surgery, SMS Medical College, Jaipur, Rajasthan, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Department of Pediatrics Surgery, SMS Medical College, Jaipur, Rajasthan, India.
authors.forename: Rajan
authors.initials: R
authors.lastname: Dagla
authors.affiliation: Department of Pediatrics Surgery, SMS Medical College, Jaipur, Rajasthan, India.
authors.forename: Lila Dhar
authors.initials: LD
authors.lastname: Agrawal
authors.affiliation: Department of Pediatrics Surgery, SMS Medical College, Jaipur, Rajasthan, India.
authors.forename: Pramila
authors.initials: P
authors.lastname: Sharma
keywords: Dysuria; erosively migrated; slit valves; ventriculoperitoneal shunt; vesical calculi