Scrotal Migration of Tubing: An Unusual Complication after Ventriculo-peritoneal Shunt

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.