Referred Shoulder Pain Due to the Positioning of the Ventriculoperitoneal Shunt: A Case Report and Literature Review of an Unusual Complication

We present the case of an 18-year-old male with a ventriculoperitoneal (VP) shunt for hydrocephalus who experienced right shoulder pain. The patient was thoroughly investigated for gastrointestinal disease, including abdominal ultrasound and upper endoscopy, which revealed no abnormalities that could explain his symptoms. X-ray imaging subsequently revealed that the shunt's distal peritoneal tubing was positioned in a supra-hepatic subdiaphragmatic location. Surgical shortening and repositioning of the peritoneal tubing successfully alleviated the patient's shoulder pain. A review of the literature uncovered four articles, comprising a total of six patients, who exhibited similar symptoms of shoulder pain linked to their VP shunts. Given the rarity of this complication, it can be easily overlooked or misdiagnosed. It is crucial for physicians to consider this possibility when evaluating patients with VP shunts who present with shoulder pain to ensure prompt and effective treatment.