AI Article Synopsis
- The text discusses a case of a 62-year-old male who experienced shunt catheter migration into the thoracic cavity after undergoing ventriculoperitoneal shunting (VPS) for hydrocephalus.
- Despite VPS being a common treatment for hydrocephalus, this case highlights a rare complication where the catheter migrated through the intercostal space between the first and second ribs into the thoracic cavity.
- The conclusion emphasizes the importance of proper subcutaneous tunneling over ribs and confirming catheter tip placement during the VPS procedure to prevent such complications.
Article Abstract
Background: Although ventriculoperitoneal shunting (VPS) is a universal treatment for hydrocephalus, it is generally well-known that the procedure often has complications. Shunt catheter migration is one such complication, but no reports of migration into the thoracic cavity are associated with the surgical technique. Herein, I present a case of thoracic cavity migration of a shunt catheter alongside anatomical pitfalls of the rib structure.
Case Description: The patient was a 62-year-old male diagnosed with subarachnoid hemorrhage due to craniocervical junction arteriovenous fistula and underwent direct surgery to occlude the fistula. We performed VPS for secondary hydrocephalus 1 month later. During VPS, the peritoneal catheter was tunneled subcutaneously over the clavicle to pass from the head to the abdomen. Several months later, the peritoneal catheter had migrated from the peritoneal cavity to the thoracic cavity. A computed tomography scan showed that the peritoneal catheter tunneled subcutaneously over the clavicle, penetrated the thoracic wall through the intercostal space between ribs 1 and 2, and entered the thoracic cavity.
Conclusion: When performing VPS, it is not enough to send the passer through the skin over the clavicle; it must also be tunneled subcutaneously over the ribs while confirming the position of the tip by touch.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10559485 | PMC |
| http://dx.doi.org/10.25259/SNI_645_2023 | DOI Listing |
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