Extrusion of Peritoneal end of Ventriculoperitoneal Shunt Catheter from Scalp Wound: A Case Report

Ventriculo Peritoneal Shunt (VPS) implantation for hydrocephalus is associated with several complications. Proximal migration of the VPS catheter is a rare complication following ventriculo-peritoneal shunting. This is a report of a management of 8-month-old-boy who had extrusion of peritoneal end of VPS catheter through scalp wound. VPS was placed at the age of 4-month for congenital / obstructive hydrocephalus. One and half month after VPS placement, he had redness and subcutaneous fluid collections around the VPS catheter tract at neck and chest area and were treated well with oral antibiotics. Four months after the shunt implantation, he was admitted with a complaint of that the end of peritoneal catheter was extruding out through scalp wound. He was managed well with removal of entire VPS tubing through scalp incision, injectable antibiotics, and delayed re-VPS placement on right side. Three-week after shunt revision, he again presented with extrusion of part of peritoneal catheter from neck area and was managed with removal of peritoneal catheter, and ventricular catheter was used as external ventricular drainage (EVD). His Computed Tomography (CT) scan of head showed dilatation of lateral ventricles (more on right side) and therefore right sided VPS was placed again after a month. Extrusion of distal / peritoneal end of VPS catheter from scalp is unique and probably not reported earlier.