10/11/2025
๐ฉ๐ฒ๐ป๐๐ฟ๐ถ๐ฐ๐๐น๐ผ๐ฝ๐ฒ๐ฟ๐ถ๐๐ผ๐ป๐ฒ๐ฎ๐น ๐ฐ๐ฎ๐๐ต๐ฒ๐๐ฒ๐ฟ ๐บ๐ถ๐ด๐ฟ๐ฎ๐๐ถ๐ผ๐ป
This is a case of distal VP catheter migration in 45y old male patient. CSF was leaking out so patient himself has given a knot at distal end.
VP shunt migration or dislodgement isย a serious complication where the shunt tubing moves from its intended position, potentially resulting in the tubing visibly "coming out" of the body through a natural or***ce or the skin
๐ฆ๐๐บ๐ฝ๐๐ผ๐บ๐ ๐ฆ๐ฝ๐ฒ๐ฐ๐ถ๐ณ๐ถ๐ฐ ๐๐ผ ๐๐ต๐๐ป๐ ๐ ๐ถ๐ด๐ฟ๐ฎ๐๐ถ๐ผ๐ป include Visible protrusion of the shunt tubingย from the skin or a natural or***ce, CSF leaking from the migration sites and signs of infection and inflammation.
๐๐ฎ๐๐๐ฒ๐ ๐ฎ๐ป๐ฑ ๐ฅ๐ถ๐๐ธ ๐๐ฎ๐ฐ๐๐ผ๐ฟ๐ ๐ผ๐ณ ๐บ๐ถ๐ด๐ฟ๐ฎ๐๐ถ๐ผ๐ป ๐ถ๐ป๐ฐ๐น๐๐ฑ๐ฒ
โข Patient Growth: In children, the body grows while the shunt tubing does not, creating tension and the potential for disconnection or migration.
โข Increased Intra-abdominal Pressure: Straining, coughing, or abdominal muscle contractions can gradually push the catheter out of the peritoneal cavity.
โข Obesity: A high BMI is an independent risk factor for distal catheter migration.
โข Surgical Factors: Inadequate anchoring of the shunt, using a long length of catheter, or a large burr hole can contribute to migration.
โข Previous Revisions: A history of multiple shunt procedures increases the risk.ย
๐๐ผ๐บ๐บ๐ผ๐ป ๐บ๐ถ๐ด๐ฟ๐ฎ๐๐ถ๐ผ๐ป ๐๐ถ๐๐ฒ๐:
Distal catheter migration is more common
โข Through the abdominal wall and skin
โข Into the sc***um (common in pediatric males due to a patent processus va**nalis)
โข Into hollow organs like the bowel, bladder, uterus, or va**na, potentially exiting through the a**s, mouth, or vulvaย
๐ ๐ฎ๐ป๐ฎ๐ด๐ฒ๐บ๐ฒ๐ป๐
If shunt migration or extrusion is suspected, it is a medical emergency requiring prompt evaluation with imaging (X-rays, CT scans) and surgical intervention. The goal of surgery is to remove the migrated portion and place a new, functioning shunt system to prevent life-threatening complications like meningitis or organ damage.
