gms | German Medical Science

Objective: Cysto-peritoneal shunting is commonly used in the treatment of arachnoid cyst. Many complications like obstruction, mechanical shunt failure, infection, and abdominal complications have been reported. Abdominal complications include migration of the distal catheter via the intestinal tract, umbilicus, and vagina. We report an unusual case of protruding abdominal catheter into the scrotum.

Method: We present a 11-month-old male patient who had arachnoid cyst at birth. Cysto-peritoneal shunt was placed at the age of 1 month. 10 months later, her mother noticed the liquid in the scrotum. Scrotal ultrasonography revealed hydrocele in the left inguinal canal and right testicle was placed abdominally. Undescended testicle (cyrptorchidism) was detected on the right side. Serum analysis and the culture of the cerebrospinal fluid (CSF) was normal. The patient underwent plain X-rays of cranium, thorax and abdomen. Abdominal X-ray showed an abnormal distal location of the catheter and cranial MRI revealed no abnormality of the proximal end of the catheter.

Results: Revision of the lower end of the shunt was done, and hydrocele disappeared until the third day after the surgery. Undescended testicle was operated by the pediatric surgeons one month later after the shunt revision surgery.

Conclusions: We report an unique patient with the protrusion of the distal catheter of cysto-peritoneal shunt into the scrotum. Pediatric neurosurgeons, pediatric surgeons and parents must always be alert for possible shunt complications.