# Pediatric Ventriculoperitoneal (VP) Shunt Catheter Migration Into the Pulmonary Trunk: A Case Report and Literature Review

## TL;DR

A 17-year-old boy had a rare complication where his VP shunt catheter migrated into his pulmonary trunk, requiring surgical removal and highlighting the importance of accurate diagnosis.

## Contribution

This case report adds to the limited literature on VP shunt catheter migration into the pulmonary trunk, emphasizing diagnostic and surgical management.

## Key findings

- Computed tomography confirmed the VP shunt catheter migration into the pulmonary trunk in a 17-year-old patient.
- Surgical removal via manual traction was successful without intraoperative complications.
- Literature review of 25 cases showed varied presentations and generally favorable surgical outcomes.

## Abstract

Ventriculoperitoneal (VP) shunting is commonly used to treat hydrocephalus, especially in pediatric patients. Despite its effectiveness, rare complications, like the migration of the distal catheter into the pulmonary trunk (PT), can occur. This case study presents a 17-year-old boy who experienced this complication, highlighting diagnostic challenges, surgical intervention, and outcomes. A review of the literature emphasizes the rarity and clinical management of such cases. A retrospective case review was conducted on a 17-year-old patient with VP shunt catheter migration into the PT. The case was managed at the Morozovskaya City Clinical Hospital, with diagnostic imaging and surgical intervention. A literature review of 25 reported cases from 1993 to 2024 was performed, focusing on demographics, clinical presentations, management strategies, and outcomes. In this case, computed tomography (CT) revealed the distal VP shunt catheter had migrated into the PT. Surgical removal via manual traction was successful, without intraoperative complications. The literature review identified 25 similar cases, most occurring in adults. Clinical presentations varied, with 25.93% being asymptomatic. Surgical outcomes were generally favorable, with few postoperative complications. Accurate diagnosis, typically via CT, is crucial for appropriate management. Surgical removal, often by manual traction under fluoroscopic guidance, is the most effective treatment. Although complications such as arrhythmias or thromboembolism can occur, timely intervention generally leads to positive outcomes, as demonstrated in this case and the literature review.