Shunt Migration into Scrotum: A Case Report

Authors

  • Muhammad Assad Javed Islamabad Medical & Dental College (IMDC), Islamabad
  • Niaz Ahmad Khan
  • Ain- us-Saba
  • Huda Sana Islamabad Medical & Dental College (IMDC), Islamabad

DOI:

https://doi.org/10.36552/pjns.v25i2.558

Keywords:

Hydrocephalus, Ventriculoperitoneal shunt, Scrotal Migration

Abstract

Ventriculoperitoneal shunting (VPS) is a common procedure involved in the management of hydrocephalus. VP shunt has many inherent complications including obstruction, infection, breakage, and migration of the shunt. The incidence of scrotal shunt migration is around 14% VPS migration into the scrotum manifests as reducible trans-illuminant scrotal swelling, which is more like hydrocele. Mostly migration occurs into the right hemi-scrotum within the first 6 months of performing a ventriculoperitoneal shunt. Bilateral herniotomy with repositioning of the distal shunt catheter is the treatment of choice.

References

1. Pudenz R.H. The surgical treatment of hydrocephalus—A historical review. Surg Neurol. 1981; 15 (1): 15–26.
2. Vuyyuru S, Ravuri SR, Tandra VR, Panigrahi MK. Anal extrusion of ventriculo peritoneal shunt tube: Endoscopic removal. J Pediatr Neurosci. 2009; 4: 124–126.
3. Harischandra LS, Sharma A, Chatterjee S. Shunt migration in ventriculoperitoneal shunting: A comprehensive review of literature. Neurol India, 2019; 67 (1): 85-99.
4. Mohammadi A, Hedayatiasl A, Ghasemi-Rad M. Scrotal migration of a ventriculoperitoneal shunt: a case report and review of literature. Med Ultrason.
2012; 14 (2): 158-160.
5. Kita D, Hayashi Y, Kinoshita M, Ohama K, Hamada J. Scrotal migration of the peritoneal catheter of a ventriculoperitoneal shunt in a 5-year-old male. Case report. Neurol Med Chir (Tokyo). 2010; 50: 1122–1125.
6. Venkataramana NK. Hydrocephalus Indian scenario A review. J Pediatr Neurosci. 2011; 6 (Suppl. 1): S11–S22.
7. Agarwal N, Shukla RM, Agarwal D, Gupta K, Luthra R, Gupta J, et al. Pediatric Ventriculoperitoneal Shunts and their Complications: An Analysis. J Indian Assoc Pediatr Surg. 2017; 22 (3): 155-157. :
8. Paulsen AH, Lundar T, Lindegaard KF. Twenty-year outcome in young adults with childhood hydrocephalus: Assessment of surgical outcome, work participation, and health-related quality of life. J Neurosurg Pediatr. 2010; 6: 527–35.
9. Agarwal T, Pandey S, Niranjan A, Jain V, Mishra S, Agarwal V. Unusual complication of ventriculoperitoneal shunt surgery. J Pediatr Neurosci. 2009; 4 (2): 122–123. -
10. Karaosmanoglu D, Metin Y, Akata D, Haliloglu M. An Unusual Cause of Hydrocele: Malpositioned Ventriculoperitoneal Shunt in the Scrotum. J Ultrasound Med. 2008; 27: 159-60.
11. Ramani PS. Extrusion of abdominal catheter of ventriculoperitoneal shunt into the scrotum. J Neurosurg. 1974; 40: 772-3.
12. Rehm A, Bannister CM, Victoratos G. Scrotal perforation by a ventriculoperitoneal shunt. Br J Neurosurg. 1997; 11: 443-4.
13. Yuksel KZ, Senoglu M, Yuksel M, Ozkan KU. Hydrocele of the canal of Nuck as a result of a rare ventriculoperitoneal shunt complication. Pediatr Neurosurg. 2006; 42: 193-6.
14. Kandasamy J, Jenkinson MD, Mallucci CL. Contemporary management and recent advances in paediatric hydrocephalus. BMJ. 2011; 343: d4191.
15. Paff M, Alexandru-Abrams D, Muhonen M, Loudon W. Ventriculoperitoneal shunt complications: A review. Interdisciplinary Neurosurgery, 2018; 13: 66-70.
16. Sarangi GS, Mohanty S, Rout SS. Late onset scrotal
migration of the distal catheter of a ventriculoperitoneal shunt in a 4-year-old male with post meningitic hydrocephalus-a case report and review of literature. International Surgery Journal, 2016; 3 (1): 390-3.
17. Bawa M, Garge S, Garg R, Narasimha Rao KL. Scrotal migration of tubing: An unusual complication after ventriculo-peritoneal shunt. Asian J Neurosurg. 2017; 12 (4): 738-740. doi:10.4103/1793- 5482.215783.
18. Ho CC, Jamaludin WJ, Goh EH, Singam P, Zain-ud-Din ZM. Scrotal mass: a rare complication of ventriculoperitoneal shunt. Acta Medica (Hradec Kralove). 2011; 54 (2): 81-82.

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Published

2021-06-14

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Section

Case Reports