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Shunt-Bronchial Fistula with Coughing Up and Swallowing of Cerebrospinal Fluid: Rare Complication of Ventriculopleural Shunt

BACKGROUND: Erosion of the distal catheter into lung parenchyma is an extremely rare complication of ventriculopleural shunt placement. CASE DESCRIPTION: We report a 51-year-old woman with a history of parasagittal meningioma invading the sagittal sinus who presented with recurrent pneumonia after p...

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Detalles Bibliográficos
Autores principales: Katsevman, Gennadiy A., Harron, Raymond, Bhatia, Sanjay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6909168/
https://www.ncbi.nlm.nih.gov/pubmed/31872190
http://dx.doi.org/10.1016/j.wnsx.2019.100065
Descripción
Sumario:BACKGROUND: Erosion of the distal catheter into lung parenchyma is an extremely rare complication of ventriculopleural shunt placement. CASE DESCRIPTION: We report a 51-year-old woman with a history of parasagittal meningioma invading the sagittal sinus who presented with recurrent pneumonia after placement of a ventriculopleural shunt. A nuclear study revealed accumulation of radiotracer material sequentially in the right hemithorax, trachea, mainstem bronchi, stomach, and bowel. The ventriculopleural shunt had eroded into the patient's lung parenchyma, with the effect of cerebrospinal fluid draining into the respiratory system and then being coughed up and swallowed into the gastrointestinal system. CONCLUSION: Surgeons should be aware of the potential complication of a ventriculopleural shunt eroding through the lung parenchyma to cause a shunt-bronchial fistula with persistent coughing and recurrent pneumonias. Shuntogram nuclear imaging may be useful in the diagnosis of the complication.