Transoral Migration of Ventriculoperitoneal Shunt: A Rare Presentation

Abstract

Ventriculoperitoneal(VP) shunt in pediatrics is a common procedure to treat variety of neurological cases. Migration of VP shunt is one of the known complications. However, the migration through transoral extrusion is extremely rare and can lead to fatal outcome. We report a case of 2 year old boy with underlying hydrocephalus with right ventriculoperitoneal shunt inserted since 7 months old. Mother notice that he has been having cough and constitutional symptoms. Upon seeking treatment, noted a tube at the back of the throat. CT scan showed that the tube pierce through the diaphragm into the bronchus, trachea and into the oral cavity.  He underwent emergency exploration and removal of shunt. under local anaesthesia and sedation. Post procedure child was monitored in critical care setting and remain well. Transoral VP shunt migration is extremely rare and uncommon. The aim is to externalize as soon as possible to prevent further complications.