Journal of Korean Neurosurgical Society

  • 제44권3호
  • /
  • Pages.170-173
  • /
  • 2008
  • /
  • 2005-3711(pISSN)
  • /
  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지

Upward Migration of Distal Ventriculoperitoneal Shunt Catheter into the Heart : Case Report

  • Chong, Jong-Yun (Department of Neurosurgery, Hanyang University Guri Hospital) ;
  • Kim, Jae-Min (Department of Neurosurgery, Hanyang University Guri Hospital) ;
  • Cho, Dong-Cham (Department of Neurosurgery, Hanyang University Guri Hospital) ;
  • Kim, Choong-Hyun (Department of Neurosurgery, Hanyang University Guri Hospital)
  • 발행 : 2008.09.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Ventriculoperitoneal (VP) shunt is commonly and effectively used to treat hydrocephalus. Intracardiac migration of the shunt catheter is a rare complication. A 68-year-old woman underwent ventriculoperitoneal shunting for hydrocephalus secondary to subarachnoid hemorrhage due to anterior communicating artery aneurysm rupture. Two weeks after the shunt surgery, she had suffered from the abdominal pain. Plain chest x-rays, computed tomography, and echocardiography revealed the distal catheter which was in the right ventricle of the heart. We tried to remove the catheter through the internal jugular vein by fluoroscopic guidance. But, the distal catheter was kinked and knotted; therefore, we failed to withdraw the catheter. After then, we punctured the right femoral vein and pulled down the multi-knotted shunt catheter to the femoral vein using the snare catheter. Finally, we removed the knotted distal catheter via the femoral vein and a new distal catheter was placed into the peritoneal cavity. We report a case in which the distal catheter of the VP shunt migrated into the heart via the internal jugular vein. We emphasize the importance of careful and proper placement of the distal catheter during the tunneling procedure to prevent life-threatening complications.

키워드

참고문헌

  1. Anegawa S, Yoshida M, Kuramoto S, Ohmori Y : [Migration of ventriculo-peritoneal shunt into the chest : case report.] Neurol Med Chir (Tokyo) 26 : 256-261, 1986 https://doi.org/10.2176/nmc.26.256
  2. Dickman CA, Gilbertson D, Pittman HW, Rekate HL, Daily WJ : Tension hydrothorax from intrapleural migration of a ventriculoperitoneal shunt. Pediatr Neurosci 15 : 313-316, 1989 https://doi.org/10.1159/000120489
  3. Fewel ME, Garton HJL : Migration of distal ventriculoperitoneal shunt catheter into the heart: case report and review of the literature. J Neurosurg (2 Suppl Pediatrics) 100 : 206-211, 2004 https://doi.org/10.3171/ped.2004.100.2.0206
  4. Frazier JL, Wang PP, Patel SH, Benson JE, Cameron DE, Hoon AH Jr, et al : Unusual migration of the distal catheter of a ventriculoperitoneal shunt into the heart : case report. Neurosurgery 51 : 819-822; discussion 822, 2002 https://doi.org/10.1097/00006123-200209000-00042
  5. Gaudio R, DeTommasi A, Occhiogrosso M, Vailati G : Respiratory distress caused by migration of ventriculoperitoneal shunt into the chest cavity : report of a case and review of the literature. Neurosurgery 23 : 768-769, 1988 https://doi.org/10.1227/00006123-198812000-00017
  6. Grabenwoeger F, Bardach G, Dock W, Pinterits F : Percutaneous extraction of centrally embolized foreign bodies : a report of 16 cases. Br J Radiol 61 : 1014-1018, 1988 https://doi.org/10.1259/0007-1285-61-731-1014
  7. Greco MA, Senesh JD, Aleksic S, Epstein F : Tricuspid stenosis secondary to entanglement of ventriculoatrial catheter in the valve leaflets. Surg Neurol 18 : 34-36, 1982 https://doi.org/10.1016/0090-3019(82)90009-X
  8. Imamura H, Nomura M : Migration of ventriculoperitoneal shunt into the heart : case report. Neurol Med Chir (Tokyo) 42 : 181-183, 2002 https://doi.org/10.2176/nmc.42.181
  9. James CA, McFarland DR, Wormuth CJ, Teo CM : Snare retrieval of migrated ventriculoatrial shunt. Pediatr Radiol 27 : 330-332, 1997 https://doi.org/10.1007/s002470050142
  10. Kang JK, Jeun SS, Chung DS, Lee IW, Sung WH : Unusual proximal migration of ventriculoperitoneal shunt into the heart. Childs Nerv Syst 12 : 176-179, 1996 https://doi.org/10.1007/BF00266827
  11. Kim BJ, Cha SH, Park DJ, Song GS, Choi CH, Lee YW : A case of intracardiac migration of distal ventriculo-peritoneal (V-P) shunt catheter: case report. J Korean Neurosurg Soc 29 : 270-273, 2000
  12. Kim HK, Seo EK, Cho YJ, Kim SJ : Hydrocephalus due to migration of ventriculoperitoneal shunt catheter. J Korean Neurosurg Soc 43 : 159-161, 2008 https://doi.org/10.3340/jkns.2008.43.3.159
  13. Kim SK, Chung C, Lee KC, Park YS, Lee YB : A case of migrated peritoneal catheter of V-P shunt system into right ventricle : case report. J Korean Neurosurg Soc 24 : 1079-1083, 1995
  14. Kubo S, Takimoto H, Takakura S, Iwaisako K, Yamanaka K, Hosoi K, et al : Peritoneal shunt migration into the pulmonary artery : case report. Neurol Med Chir (Tokyo) 42 : 572-574, 2002 https://doi.org/10.2176/nmc.42.572
  15. Morell RC, Bell WO, Hertz GE, D'Souza V : Migration of a ventriculoperitoneal shunt into the pulmonary artery. J Neurosurg Anesthesiol 6 : 132-134, 1994 https://doi.org/10.1097/00008506-199404000-00010
  16. Taub E, Lavyne MH : Thoracic complications of ventriculoperitoneal shunts : case report and review of the literature. Neurosurgery 34 : 181-183; discussion 183-184, 1994 https://doi.org/10.1227/00006123-199401000-00028
  17. Uflacker R, Lima S, Melichar AC : Intravascular foreign bodies : percutaneous retrieval. Radiology 160 : 731-735, 1986 https://doi.org/10.1148/radiology.160.3.3737911