Unusual migration of distal ventriculoperitoneal shunt to Vagina via fallopian tube: A case report

A Unique Case of Gastric Band Tubing Eroding Into the Vaginal Cuff

We present here the case of a woman in her 40s with a history of an adjustable gastric band placed a decade ago. After the initial procedure, she had issues with a port-site hernia, mesh placement, and explantation secondary to mesh infection. Her port was removed at the time, with the tubing left in situ with hopes of future salvage. She then presented to her gynecologist with the tubing eroding through her vaginal cuff. This case highlights the importance of having a high index of suspicion in patients with a history of gastric bands given the varying presentation in the event of a complication.

Upward Migration and Coiling of the Distal Catheter Toward the Valve Site

Hydrocephalus, which is caused by the accumulation of cerebrospinal fluid (CSF), is a common condition in children. It is known to be most likely treated by the insertion of a ventriculoperitoneal (VP) shunt. However, a VP shunt can lead to multiple complications. The upward migration of a VP shunt is considered rare.

A newborn male baby with a known case of Chiari malformation type 2 associated with myelomeningocele (MMC) and hydrocephalus had a VP shunt inserted for control of the hydrocephalus. He presented two months after the surgery with occipital swelling at the surgical site. Shunt series followed by Computerized tomography (CT) scan showed that the distal end of the catheter had migrated upward and coiled around the valve. Urgent revision of the VP shunt was performed.

Reabsorption of subgaleal fluid, increased abdominal pressure, repeated abdominal wall contraction, and repeated head motion of the child are the previously suggested theories of upward migration of distal catheter to the site of the valve. However, the combination of multiple theories can be the logical explanation, as they do not oppose each other.