Scrotal migration of peritoneal end of ventriculo-peritoneal (VP) shunt into the patent
processus vaginalis (PPV) is a rare complication. Its exact incidence is not mentioned
in the literature till date. This may be because of the rarity of this complication,
and also because all previous articles related to the complication were case reports.
We, in our series, had an incidence of 0.9%. This prospective study has been conducted
on 437 patients in the age group of 1 month–3 years who underwent VP shunt for hydrocephalus
over a period of 5 years from 2007 to 2011. The incidence of a hernia manifesting
after shunt insertion has been reported to be around 16.8%. The average age of patients
at the time of insertion of the shunt was 27.25 months (3–48 months). All our patients
presented with swollen right sided scrotum after an average of 4 months (3–5 months)
after shunt insertion. Shunt migration was more common on the right which is consistent
with the incidence of hernias in children. The proper management of such cases includes
repositioning of the catheter with the proper closure of the PPV. Usually, shunt revision
is not required. We discuss the etiology, treatment and preventive measures of this
rare entity.
Key-words:
Complications - hernia - patent processus vaginalis - shunt migration - ventriculo-peritoneal
shunt
