ABSTRACT
Cerebrospinal fluid (CSF) shunting has been a mainstay in the treatment of hydrocephalus for many decades. With a reported 33,000 shunt placement procedures performed in the US annually, and a lifetime revision rate approaching 50%, abdominal radiologists must be familiar with the typical imaging appearance of an array of shunt complications. Complications related to the peritoneal portion of the shunt have been reported in up to 25% of patients. We present a comprehensive pictorial essay including computed tomography, conventional radiography, ultrasound, and nuclear medicine examples illustrating abdominal complications related to CSF shunting and a review of the current literature. The purpose of this pictorial essay is to provide multimodality imaging examples of CSF shunt complications and familiarize the abdominal imager with the spectrum of findings.
Subject(s)
Cerebrospinal Fluid Shunts/adverse effects , Hydrocephalus/surgery , Abdominal Cavity , Humans , Hydrocephalus/diagnostic imaging , Postoperative Complications/diagnosis , RadiographyABSTRACT
We report a case of an abandoned abdominal ventriculoperitoneal shunt that migrated into the gastric antrum, colonic hepatic flexure, and liver parenchyma, which was discovered incidentally on an abdominal CT obtained for renal stones. In regards to the migrated abandoned VP shunt, the patient was asymptomatic. Upon review of prior CT scans, these findings had progressed over approximately 7 years. We describe the case and discuss the clinical and radiologic findings, complications resulting from ventriculoperitoneal shunts, and possible approaches to their management.
