Migration of the Distal End of a Ventriculoperitoneal Shunt Into the Abdominal Wall in an Obese Patient —Case Report—

Kuniaki NAKAHARA; Satoru SHIMIZU; Hidehiro OKA; Satoshi UTSUKI; Hideo IIDA; Kiyotaka FUJII

doi:10.2176/nmc.49.490

Case Reports

Migration of the Distal End of a Ventriculoperitoneal Shunt Into the Abdominal Wall in an Obese Patient

—Case Report—

Kuniaki NAKAHARA, Satoru SHIMIZU, Hidehiro OKA, Satoshi UTSUKI, Hideo IIDA, Kiyotaka FUJII

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Keywords: ventriculoperitoneal shunt, abdominal wall, obesity, migration, catheter

JOURNAL OPEN ACCESS

2009 Volume 49 Issue 10 Pages 490-492

DOI https://doi.org/10.2176/nmc.49.490

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Abstract

A 64-year-old obese woman underwent ventriculoperitoneal shunting for hydrocephalus associated with subarachnoid hemorrhage. On the 10th postoperative day, the distal end of the peritoneal catheter migrated into the abdominal wall and she developed a cyst filled with cerebrospinal fluid around the migrated catheter. The distal end of the catheter was surgically repositioned. We attribute the migration to increased intra-abdominal pressure due to obesity, the use of a low friction hydrogel-processed peritoneal catheter, and the presence of a large dead space around the catheter. The laparotomy must be closed meticulously to prevent this type of migration.

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