Spontaneous Extrusion of Ventriculopleural Shunt Catheter Associated with Pleural Effusion.

Background: Ventriculopleural (VPL) shunts are used infrequently in management of hydrocephalus. The main complication associated with these shunts is pleural effusion.

Case Description: A 28-year-old man with a history of congenital hydrocephalus had a VPL shunt inserted. Two years later, he noticed a soft bulging in the surgical scar area of the chest, suggestive of fluid accumulation. The scar subsequently opened up spontaneously exposing the distal catheter, which extruded through the opening. Chest radiographs and computed tomography scan showed an important pleural effusion on the same side. The VPL shunt was removed, and a contralateral shunt was inserted.

Conclusions: To our knowledge, spontaneous extrusion of the distal catheter of a VPL shunt has not been previously reported in the literature. Physicians treating patients with hydrocephalus must be aware of this potential complication when a VPL shunt is inserted.