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Carvalho RP, Picazio LFP, Kawahara LT, Kawahara NT, de Aguiar PHP. Distal catheter fixation in ventriculoperitoneal shunt by videolaparoscopy - Technical note. Surg Neurol Int 2025; 16:119. [PMID: 40353156 PMCID: PMC12065519 DOI: 10.25259/sni_1090_2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Accepted: 03/03/2025] [Indexed: 05/14/2025] Open
Abstract
Background Ventriculoperitoneal shunt (VPS) is widely used in the treatment of hydrocephalus (HC), but it is frequently associated with complications such as migration and obstruction of the distal catheter, which can impact therapeutic success. Inadequate fixation of the catheter is one of the primary causes of these complications. Laparoscopic techniques involving fixation of the catheter at two points have been proposed to reduce the risk of migration and improve outcomes, although the literature still lacks consensus on the ideal technique. Methods An 80-year-old obese female presented with ataxia, headache, urinary incontinence, and papilledema. HC was confirmed by computed tomography. The patient underwent a right VPS using an innovative laparoscopic technique for distal catheter fixation. After the placement of the ventricular catheter and programmable valve, the distal catheter was secured with two 2-0 polypropylene sutures and two loops in the right paracolic gutter. Results The patient progressed well, with no complications in the immediate postoperative period. The fixation was effective in preventing distal catheter migration and reducing obstruction. The laparoscopic approach was successful. Conclusion Laparoscopic fixation of the distal catheter with two sutures and loops is a promising technique to improve VPS outcomes, reducing complications. However, further studies are needed to confirm its long-term efficacy and safety.
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Affiliation(s)
| | | | | | - Nilton Tokio Kawahara
- Department of Surgery, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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Ghritlaharey RK. Migration of the distal ventriculoperitoneal shunt catheter into the stomach with or without trans-oral extrusion: A systematic literature review and meta-analysis. World J Clin Pediatr 2023; 12:331-349. [PMID: 38178931 PMCID: PMC10762601 DOI: 10.5409/wjcp.v12.i5.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/04/2023] [Accepted: 10/30/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt (VPS) catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter insertion. AIM To identify the demographics, clinical presentation, clinical findings, and results of surgical therapy offered for the treatment of intra-gastric migration of the distal VPS catheter, clinically presented with or without trans-oral extrusion. METHODS An online search was performed for the extraction/retrieval of the published/ available literature pertaining to the above-mentioned VPS complication. Manuscripts were searched from PubMed, PMC (PubMed Central), ResearchGate, and Google Scholar databases using various terminology relating to the VPS complications. The first case of migration of a VPS catheter into the stomach was reported in the year 1980, and the data were retrieved from 1980 to December 2022. Cases were categorized into two groups; Group A: Cases who had migration of the distal VPS catheter into the stomach and clinically presented with trans-oral extrusion of the same, and Group B: Cases who had migration of the distal VPS catheter into the stomach, but presented without trans-oral extrusion. RESULTS A total of n = 46 cases (n = 27; 58.69% male, and n = 19; 41.3% females) were recruited for the systematic review. Group A included n = 32, and Group B n = 14 cases. Congenital hydrocephalus was the indication for the primary VPS insertion for approximately half of the (n = 22) cases. Approximately sixty percent (n = 27) of them were children ≤ 5 years of age at the time of the diagnosis of the complication mentioned above. In seventy-two percent (n = 33) cases, this complication was detected within 24 mo after the VPS insertion/last shunt revision. Clinical diagnosis was evident for the entire group A cases. Various diagnostic modalities were used to confirm the diagnosis for Group B cases. Various surgical procedures were offered for the management of the complication in n = 43 cases of both Groups. In two instances, intra-gastric migration of the distal VPS catheter was detected during the autopsy. This review documented four deaths. CONCLUSION Intra-gastric migration of the peritoneal end of a VPS catheter is one of the rare complications of VPS catheter implantation done for the treatment of hydrocephalus across all age groups. It was more frequently reported in children, although also reported in adults and older people. A very high degree of clinical suspicion is required for the diagnosis of a case of an intra-gastric migration of the distal VPS catheter clinically presenting without trans-oral extrusion.
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Affiliation(s)
- Rajendra Kumar Ghritlaharey
- Department of Paediatric Surgery, Gandhi Medical College and Associated, Kamla Nehru and Hamidia Hospitals, Bhopal 462001, Madhya Pradesh, India
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3
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Nakamura H. [A case of bacterial meningitis due to colon perforation of V-P shunt tube in an elderly patient with prolonged high fever after hospitalization for urinary tract infection]. Nihon Ronen Igakkai Zasshi 2022; 59:551-558. [PMID: 36476704 DOI: 10.3143/geriatrics.59.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
An 86-year-old woman who had received a V-P shunt for subarachnoid hemorrhage 23 years previously presented to the emergency room with a chief complaint of fever. The diagnosis on admission was urinary tract infection, and treatment with CMZ was started. Abdominal CT scan on admission revealed that the V-P shunt had penetrated the ascending colon; however, because there were no clinical symptoms or imaging findings suggestive of peritonitis or meningitis, the V-P shunt was not initially considered to be related to the fever. However, since the fever in the 39°C range persisted for a week despite a urine culture showing susceptible Escherichia coli, a spinal fluid examination was performed on the assumption of meningitis caused by the V-P shunt. We found elevated cell counts in the CSF and diagnosed the patient with bacterial meningitis. After shunt removal surgery was performed, the patient quickly recovered from fever. Later, Pseudomonas aeruginosa was detected at the shunt tube and in the CSF, and CFPM was administered continuously. The patient was discharged with good progress.A review of the relevant literature revealed that half of the patients with a V-P shunt penetrating the intestinal tract will pass asymptomatically and are unlikely to develop peritonitis, while half of the patients may develop meningitis. In addition, if there is an artifact in the body, it is always necessary to consider the possibility that it may be the source of infection.
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Scarascia A, Atallah E, Pineda MDA, Rosenwasser R, Judy K. Gastric perforation from a migrating ventriculoperitoneal shunt: A case report and review of literature. Radiol Case Rep 2022; 17:4899-4902. [PMID: 36281285 PMCID: PMC9587122 DOI: 10.1016/j.radcr.2022.09.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/14/2022] [Accepted: 09/18/2022] [Indexed: 11/01/2022] Open
Abstract
Ventriculoperitoneal (VP) shunts represent a surgical option for patients affected by increased intracranial hypertension when medical management fails or is contraindicated. Complications following implantation include shunt obstruction, infection, over and under drainage, migration or disconnection of the tube, formation of a pseudocyst, and allergy to the silicone tube. We report the case of a 31-year-old woman who presented to the emergency room with nausea and generalized malaise, found to have the distal segment of the VP catheter perforating her gastric wall into the stomach lumen which required surgical intervention. In this report, we describe a rare complication associated with the implantation of ventriculoperitoneal shunt (VPS) catheters and the subsequent management plan.
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Affiliation(s)
- Alessio Scarascia
- Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168 Rome RM, Italy,Corresponding author.
| | - Elias Atallah
- Thomas Jefferson University, 1020 Walnut St, Philadelphia, PA 19107, USA
| | | | - Robert Rosenwasser
- Thomas Jefferson University, 1020 Walnut St, Philadelphia, PA 19107, USA
| | - Kevin Judy
- Thomas Jefferson University, 1020 Walnut St, Philadelphia, PA 19107, USA
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Chen YH, Hsieh CT, Sun JM, Chang SI. Gastric perforation by a ventriculoperitoneal shunt in an adult. NEUROSCIENCES (RIYADH, SAUDI ARABIA) 2020; 25:144-147. [PMID: 32351252 PMCID: PMC8015529 DOI: 10.17712/nsj.2020.2.20190118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Ventriculoperitoneal (VP) shunt operation is a common neurosurgical procedure applied for managing intracranial hydrocephalus. Migration of a distal catheter is an uncommon complication, and related gastric perforation is rarely reported. Herein, we report the case of gastric perforation in a patient with VP shunt who presented with fever. The distal catheter within the stomach was confirmed by preoperative computed tomographic scan of abdomen and gastric endoscopy. Surgical intervention and appropriate antibiotics management enabled patient recovery. This case emphasizes the importance of early recognition and surgical intervention in this rare complication related to the shunt procedure. Received 9th December 2019. Accepted 23th January 2020.
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Affiliation(s)
- Yu-Hao Chen
- Section of Neurosurgery, Department of Surgery, Chia-Yi Christian Hospital, Chia-Yi City 600, Taiwan
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Ichikawa Y, Matsuda C, Mizushima T, Takahashi H, Miyoshi N, Haraguchi N, Hata T, Yamamoto H, Doki Y, Mori M. Safety of laparoscopic colorectal surgery in patients with ventriculoperitoneal shunt. Asian J Endosc Surg 2019; 12:264-268. [PMID: 30133170 DOI: 10.1111/ases.12640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/05/2018] [Accepted: 07/16/2018] [Indexed: 01/18/2023]
Abstract
INTRODUCTION This study retrospectively investigated the safety of laparoscopic colorectal surgery in patients with ventriculoperitoneal shunt (VPS) based on the experiences within our department. METHODS A total of 866 patients underwent laparoscopic colorectal surgery for colorectal cancer, ulcerative colitis, Crohn's disease, and acute appendicitis at Osaka University during the study period. Laparoscopic colorectal surgery cases were collected from the Osaka University database. Among them, four (0.5%) had VPS when they underwent surgery. In these four cases, we consulted a neurosurgeon and checked the route of the VPS catheter to determine whether it had a unidirectional valve to prevent backflow and whether it was working normally. We retrospectively investigated the clinical characteristics of these four cases. RESULTS All cases were safely treated, with the pneumoperitoneum pressure set at 10 mmHg under routine anesthetic monitoring and without any manipulations such as clamping or externalization of the VPS catheter. The four patients were discharged without any VPS-related complications such as increased intracranial pressure, shunt failure, or infection. CONCLUSIONS Our study suggests that laparoscopic colorectal surgeries in patients with VPS without any manipulations may be safe. Future studies should aim to better standardize the perioperative management of VPS during laparoscopic colorectal surgery.
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Affiliation(s)
| | - Chu Matsuda
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tsunekazu Mizushima
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hidekazu Takahashi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Norikatsu Miyoshi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Naotsugu Haraguchi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Taishi Hata
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hirofumi Yamamoto
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masaki Mori
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
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Sidhu JS, Mandal A, Kafle P, Chaulagai B, Gayam V. Ventriculoperitoneal Shunt Migration Inside the Gastric Lumen: A Rare Case Report. Cureus 2019; 11:e4453. [PMID: 31205839 PMCID: PMC6561512 DOI: 10.7759/cureus.4453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Ventriculoperitoneal (VP) shunt placement is one of the more common procedures in neurosurgery and has a variety of indications. However, shunt placement can be associated with multiple complications, one of which is proximal and distal shunt migration. There have been reported cases of migration of the distal end of a VP shunt from the intraperitoneal cavity into different organs resulting in a variety of complications. Most of the reported cases are the result of spontaneous migration. However, shunt catheter migration could be iatrogenic as well. We present a case of intragastric VP shunt migration in a patient following placement of a percutaneous endoscopic gastrostomy tube.
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Affiliation(s)
| | | | - Paritosh Kafle
- Internal Medicine, Interfaith Medical Center, Brooklyn, USA
| | | | - Vijay Gayam
- Internal Medicine, Interfaith Medical Center, Brooklyn, USA
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Soufiany I, Hijrat KA, Soufiany S, Chen L. Mechanisms and Major Sites of Distal Catheter Migration in Ventriculoperitoneal Shunting Maneuvers: A Review Article. BRAIN SCIENCE ADVANCES 2019. [DOI: 10.26599/bsa.2018.9050002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
A ventriculoperitoneal shunt (VPS) is a medical device used to deflect cerebrospinal fluid from cerebral ventricles to the peritoneal cavity. Since 1908, ventriculoperitoneal shunts have been considered the best option in hydrocephalus management. Manifestation related to VPS may arise anywhere whilst tunneling the VPS from the ventricle to the peritoneal cavity, but complications associated with the distal catheter are especially common and a leading cause of revision surgeries. Among the many complications associated with peritoneal shunts, migration of the catheter into other parts of the body is still common. Scrotal migration mainly takes place in children aged 4 days to 5 years. Patent processus vaginalis, formation of an inguinal hernia, and increased intraabdominal pressure are leading risk factors associated with migration of the peritoneal catheter into the scrotum. Thoracic migration of peritoneal catheters predominantly occurs in adult patients. Important mechanisms in thoracic migration include (1) iatrogenic perforation of the external or internal jugular veins by the surgeon during tunneling and (2) gradual destruction of the venous structures by the catheter due to routine extension and flexion of the neck. After entering the vessel, negative intrathoracic pressure combined with positive intraabdominal pressure aids migration into the thoracic cavity. Sharp tips or shunt types contribute to intraabdominal migration and perforation.
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Affiliation(s)
- Ismatullah Soufiany
- Department of Neurosurgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Khalil Ahmad Hijrat
- Department of General Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Spina Soufiany
- Department of Gynecology/Obstetrics, Mirwais Hospital, School of Medicine, Kandahar University, Kandahar 3802, Afghanistan
| | - Lukui Chen
- Department of Neurosurgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
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9
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Allouh MZ, Al Barbarawi MM, Asfour HA, Said RS. Migration of the distal catheter of the ventriculoperitoneal shunt in hydrocephalus: A Comprehensive Analytical Review from an Anatomical Perspective. Clin Anat 2017. [PMID: 28622424 DOI: 10.1002/ca.22928] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
There have been many reports on migration of the distal catheter of the ventriculoperitoneal shunt (VPS) since this phenomenon was recognized 50 years ago. However, there have been no attempts to analyze its different patterns or to assess these patterns in terms of potential risk to patients. We comprehensively reviewed all reports of distal VPS catheter migration indexed in PubMed and identified three different anatomical patterns of migration based on catheter extension and organs involved: (1) internal, when the catheter invades any viscus inside the thoracic, abdominal, or pelvic cavity; (2) external, when the catheter penetrates through the body wall either incompletely (subcutaneously) or completely (outside the body); and (3) compound, when the catheter penetrates a hollow viscus and protrudes through a pre-existing anatomical orifice. We also analyzed the association between each migration type and several key factors. External migration occurred mostly in infants. In contrast, internal migration occurred mostly in adults. A body wall weakness was not a risk factor for catheter protrusion. Shunt duration was a critical factor in the migration pattern, as most newly-replaced shunts tended to migrate externally. Clinicians must pay close attention to cases of large bowel perforation, since they were most often associated with intracranial infections. The organ involved in compound migration could determine the route of extrusion, as the bowel was involved in all trans-anal migrations and the stomach in most trans-oral cases. Clin. Anat. 30:821-830, 2017. © 2017Wiley Periodicals, Inc.
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Affiliation(s)
- Mohammed Z Allouh
- Department of Anatomy, Faculty of Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan
| | - Mohammed M Al Barbarawi
- Division of Neurosurgery, Department of Neurosciences, Faculty of Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan
| | - Hasan A Asfour
- Department of Anatomy, Faculty of Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan
| | - Raed S Said
- Department of Anatomy, Faculty of Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan
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10
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Rinker EK, Williams TR, Myers DT. CSF shunt complications: what the abdominal imager needs to know. ACTA ACUST UNITED AC 2015; 40:2030-40. [DOI: 10.1007/s00261-015-0366-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rinker EK, Osborn DA, Williams TR, Spizarny DL. Asymptomatic bowel perforation by abandoned ventriculoperitoneal shunt. J Radiol Case Rep 2013; 7:1-8. [PMID: 24421952 PMCID: PMC3888181 DOI: 10.3941/jrcr.v7i9.1243] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report a case of an abandoned abdominal ventriculoperitoneal shunt that migrated into the gastric antrum, colonic hepatic flexure, and liver parenchyma, which was discovered incidentally on an abdominal CT obtained for renal stones. In regards to the migrated abandoned VP shunt, the patient was asymptomatic. Upon review of prior CT scans, these findings had progressed over approximately 7 years. We describe the case and discuss the clinical and radiologic findings, complications resulting from ventriculoperitoneal shunts, and possible approaches to their management.
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Affiliation(s)
- Eric K Rinker
- Department of Radiology, Henry Ford Hospital, Detroit, USA
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Poilblanc M, Sentilhes L, Mercier P, Lefèbvre C, Descamps P. Uterine perforation by a cystoperitoneal shunt, an unusual cause of recurrent vaginal discharge. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2012; 34:63-65. [PMID: 22260765 DOI: 10.1016/s1701-2163(16)35135-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND We describe the first reported case of uterine perforation by a cystoperitoneal shunt. The mechanism of this unusual complication is unclear. CASE A 17-year-old patient had a cystoperitoneal shunt for a porencephalic cyst. She presented with recurrent watery vaginal discharge. A pelvic ultrasound examination showed that the uterus had been perforated by the distal tip of the shunt. The cystoperitoneal shunt was converted to a ventriculo-atrial shunt, and the vaginal discharge subsequently resolved. CONCLUSION The appearance of light and clear vaginal discharge in a patient with a cystoperitoneal shunt raises the possibility of uterine perforation. This can be confirmed by ultrasound and analysis of the discharge. Removal of the shunt leads to spontaneous closure of the uterine defect.
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Affiliation(s)
- Mathieu Poilblanc
- Department of Gynecologic Oncology, Notre-Dame Hospital, Montreal University Hospital, Montreal QC
| | - Loïc Sentilhes
- Department of Obstetrics and Gynecology, Angers University Hospital, Angers Cedex, France
| | - Philippe Mercier
- Department of Neurosurgery, Angers University Hospital, Angers Cedex, France
| | - Céline Lefèbvre
- Department of Obstetrics and Gynecology, Angers University Hospital, Angers Cedex, France
| | - Philippe Descamps
- Department of Obstetrics and Gynecology, Angers University Hospital, Angers Cedex, France
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Hai A, Rab AZ, Ghani I, Huda MF, Quadir AQ. Perforation into gut by ventriculoperitoneal shunts: A report of two cases and review of the literature. J Indian Assoc Pediatr Surg 2011; 16:31-3. [PMID: 21430848 PMCID: PMC3047774 DOI: 10.4103/0971-9261.74521] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We report two cases of gastrointestinal perforation by ventriculoperitoneal (VP) shunts and review the literature on the topic. The time interval between shunt surgery and detection of bowel perforation is minimum in infants and increases with age. Sigmoid and transverse colon followed by stomach are the most frequent sites of gastrointestinal perforations by VP shunts.
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Affiliation(s)
- Abdul Hai
- Department of Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Silva Neto AR, Bezerra MJD, Farias MCS, Câmara RLB. Unusual extrusion of ventriculoperitoneal shunt. Acta Neurochir (Wien) 2011; 153:203-4. [PMID: 20842511 DOI: 10.1007/s00701-010-0797-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 09/02/2010] [Indexed: 11/24/2022]
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Cheng JYS, Lo WC, Liang HH, Kun IH. Migration of ventriculoperitoneal shunt into the stomach, presenting with gastric bleeding. Acta Neurochir (Wien) 2007; 149:1269-70. [PMID: 17999030 DOI: 10.1007/s00701-007-1413-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2007] [Accepted: 10/03/2007] [Indexed: 10/22/2022]
Abstract
We present an extremely rare complication after ventriculoperitoneal shunting. The peritoneal tube migrated into the stomach 8 months after the operation and patient presented with gastric bleeding.
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