The Gordian knot of hydrocephalus: constrictive entanglement of distal ventriculoperitoneal shunt catheter

Childs Nerv Syst. 2023 Mar;39(3):829-831. doi: 10.1007/s00381-022-05677-3. Epub 2022 Sep 19.

Abstract

We recently cared for a patient with a distal ventriculoperitoneal shunt malfunction. The peritoneal catheter was coiled in a scarred pseudocyst, and we encountered strong resistance while attempting to remove the distal shunt catheter. The catheter was successfully removed under laparoscopic guidance and was found to be tightly coiled in a constrictive knot. We describe a technique for managing this unusual presentation to minimize the risk of complications.

Keywords: Hydrocephalus; Knot; Laparoscopy; Pseudocyst; Ventriculoperitoneal shunt.

Publication types

  • Case Reports

MeSH terms

  • Catheters, Indwelling
  • Constriction, Pathologic / surgery
  • Humans
  • Hydrocephalus* / diagnostic imaging
  • Hydrocephalus* / surgery
  • Laparoscopy* / methods
  • Peritoneal Cavity / surgery
  • Ventriculoperitoneal Shunt / adverse effects
  • Ventriculoperitoneal Shunt / methods