Late Transurethral Extrusion of a Ventriculoperitoneal Shunt Catheter in an Adult Female: A Case Report and Review of Management

Moatasem Ali Al-Asali¹, Osama Mohammad Jamous²

Keywords: Ventriculoperitoneal shunt, shunt complication, bladder perforation, urethralextrusion, transurethral migration, case report, adult patient

DOI: 10.63475/yjm.v5i1.0364

DOI URL: https://doi.org/10.63475/yjm.v5i1.0364

Publish Date: 29-04-2026

Download PDF

Pages: 201 - 205

Views: 5

Downloads: 13

Citation: 0

Author Affiliation:

1 Resident Neurosurgeon, Neurosurgery Department, Al-Basheer Hospital, Jordanian Ministry of Health, Amman, Jordan
2 Consultant Neurosurgeon, Neurosurgery Department, Al-Basheer Hospital, Jordanian Ministry of Health, Amman, Jordan

Abstract

This case describes an unusual instance of late transurethral extrusion of a ventriculoperitoneal shunt catheter in a 44-year-old woman. The patient exhibited an atypical clinical presentation, initially showing no signs of systemic infection or acute neurological decline. Diagnostic imaging confirmed the migration of the distal catheter through the bladder wall and into the urethra. Although there were minimal initial symptoms, subsequent cerebrospinal fluid (CSF) analysis indicated a rapidly progressing pleocytosis. A multidisciplinary surgical strategy was implemented, which included proximal shunt externalization, transurethral extraction of the distal catheter, and the placement of an external ventricular drain (EVD). Microbiological testing detected Brevundimonas spp. in the CSF and Klebsiella pneumoniae in the sputum. After targeted antibiotic treatment and a successful EVD challenge, the shunt system was entirely removed without any recurrence of hydrocephalus. This case underscores that transurethral extrusion can occur as a late complication in adults and highlights the importance of maintaining a high index of clinical suspicion and employing a multidisciplinary approach to achieve positive outcomes.

---