Rare complication of ventriculoperitoneal shunt. Earlyonsetofdistal catheter migration into scrotum in an adult male: Casereportand literature review

INTRODUCTION: The role of shunt placement is to divert cerebrospinal fluid from within the ventricles to analternativelocationinthesettingofhydrocephalus. One of the rare shunt complications is distal catheter migration, andvariousbodysiteshavebeenreported, includingthescrotum. Althoughcasesof scrotal migration of distal catheter have been reported in pediatric patients, cases in adult patients are rare duetoobliteratedprocessusvaginalis. Furthermore, there has not been a case reported for scrotal migration in an adult at an early onset. PRESENTATION OFCASE: 65-year-old male underwent shunt placement for normal-pressure hydrocephalus- like symptoms. On post-operative day seven patient developed right testicular edema, for which ultrasound was performed, revealing hydrocele along with the presence of distal catheter in the scrotum. On post-operative day nine patient underwent distal catheter trimming via laparo-scopic approach with general surgery, with post-operative imaging showing satisfactory location of distal catheter intheperitonealcavity. DISCUSSION/ CONCLUSION: Early onset of distal catheter migration into scrotum in an adult male is a unique case, as most cases are reported in pediatric patients, and it is the first case reported in the English literature to have occurrence at an early onset during the peri-operative period. Asourcase demonstrates, early occurrence and detection of scrotal migration of the distal catheter prevent shunt malfunction. Prompt surgical management of catheter repositioning is therefore recommended to avoid the riskoffurthercomplications. (C) 2014TheAuthors. PublishedbyElsevierLtd.