Document Detail

Migration of distal ventriculoperitoneal shunt catheter into the heart. Case report and review of the literature.
MedLine Citation:
PMID:  14758952     Owner:  NLM     Status:  MEDLINE    
Migration of distal ventriculoperitoneal shunt tubing is known to occur in a wide of variety of locations. The authors report an unusual complication involving a previously confirmed intraperitoneal shunt catheter that migrated into the heart and pulmonary vasculature. Radiographic evidence suggested that this occurred secondary to cannulation of a segment of the external jugular vein with a shunt trochar during tunneling of the distal catheter. This is the sixth reported case of a peritoneal shunt tube migrating proximally into the heart. The authors review the literature regarding migration of distal tubing into the heart and pulmonary artery. Based on imaging studies obtained in the present case, the authors posit that the mechanism for this unusual type of shunt migration is inadvertent penetration of either the internal or external jugular vein during the initial tunneling procedure. Negative intrathoracic pressure and slow venous flow then draws the catheter out of the peritoneum and into the vasculature. The distal catheter then migrates into the right side of the heart and pulmonary artery. Diagnosis and management of this type of complication is discussed.
Matthew E Fewel; Hugh J L Garton
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  100     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-04     Completed Date:  2004-02-17     Revised Date:  2005-04-14    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  206-11     Citation Subset:  AIM; IM    
Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan 48109-0338, USA.
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MeSH Terms
Brain Concussion / complications*,  radiography
Equipment Failure
Foreign-Body Migration / radiography*
Heart* / radiography
Hydrocephalus / radiography,  surgery*
Postoperative Complications / radiography*
Pulmonary Artery* / radiography
Tomography, X-Ray Computed
Ventriculoperitoneal Shunt / instrumentation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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