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Journal of Pediatric Neurology 2013; 11(02): 119-122
DOI: 10.3233/JPN-130607
Case Report
Georg Thieme Verlag KG Stuttgart – New York

Cerebrospinal fluid hydrothorax, an unusual complication of ventriculoperitoneal shunt

Essam A. Elgamal
a   Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
,
Fawaz S. Almotairi
a   Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
,
Asaad M. Abdullah
b   Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
,
Mustafa A.M. Salih
b   Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
› Author Affiliations
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Publication History

14 May 2012

31 August 2012

Publication Date:
30 July 2015 (online)

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Abstract

Cerebrospinal fluid (CSF) hydrothorax is a very rare complication following ventriculoperitoneal (VP) shunt. We report a 14-month-old boy, who was diagnosed to have open neural tube defect associated with ventriculomegaly. He underwent VP shunt at the age of 1 months. He presented with high-grade fever, shortness of breath, tachypnea, wheezy chest, and productive cough. Plain chest X-ray and computerized tomography revealed pleural effusion with distal catheter of the shunt located in the right pleural cavity. He underwent externalization of the distal catheter followed by VP shunt revision. In the present case, CSF hydrothorax resulted from migration of the distal catheter into the pleural cavity. We reviewed 17 hitherto reported cases in the literature and the causes that lead to CSF hydrothorax are discussed. We emphasize the importance of careful and proper placement of the distal catheter during the tunneling procedure to prevent life-threatening complications.

Keywords

Neural tube defects - hydrothorax - ventriculoperitoneal shunt - hydrocephalus - child