Scrotal migration of a ventriculoperitoneal shunt in an adult. A case report and literature review.

Scrotal migration of a ventriculoperitoneal shunt (VPS) catheter is a rare complication of VPS. Scrotal migrations usually manifest in the first year post-operatively, usually in the pediatric population, due to processus vaginalis patency and increased abdominal pressure. To review cases of scrotal migration of a VPS catheter that occur in the adult population, and its recommended management. A case report and review of the literature. A 75-year-old male with a ventriculoperitoneal shunt for normal pressure hydrocephalus, presented with testicular swelling. Imaging revealed that the distal shunt catheter had migrated into his scrotum. He required an emergency shunt revision, with a truncation of the catheter, and involvement of the general surgical team for hernia management. He remained well at one year follow-up. To the best of our knowledge, this is the fifth case in an adult. This case serves as a reminder to take a thorough clinical history, imaging of the entire VPS pathway, and to consider unusual reasons for VPS failures. Emergency intervention for distal shunt revision is required to prevent further neurological or urological morbidity. Treatment includes not only catheter revision and reinsertion, but the catheter should be truncated, to avoid testicular migration recurrence. Hernia repair can be done either as an emergency or elective case, depending on the patient's clinical status and presentation.

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© 2022 The Authors. Published by Elsevier B.V. on behalf of EUROSPINE, the Spine Society of Europe, EANS, the European Association of Neurosurgical Societies.

Déclaration de conflit d'intérêts

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.