case_images: PMC10559485_01
case_images: Perioperative imaging findings. (a) Abdominal X-ray, taken on ventriculoperitoneal shunting postoperative day 1, showing a peritoneal catheter (white arrows) placed within the peritoneal cavity. (b) Computed tomography (CT), taken before shunt reconstruction, volume rendering of the pulmonary structure, showing the migration of the peritoneal catheter (white arrows) into the thoracic cavity. (c) Coronal chest CT image, taken before shunt reconstruction, showing pleural effusion (black arrows) around the peritoneal catheter (white arrows) in the thoracic cavity. (d and e) Volume rendering CT of the bone, cranial axial plane image and operative view, showing the peritoneal catheter entering the thoracic cavity through the intercostal space between ribs 1 and 2 despite passing over the clavicle. Note that there is a risk of mistakenly inserting the peritoneal catheter into the thoracic cavity due to the wide intercostal space between ribs 1 and 2, and ribs 2 and 3.
case_images: SNI-14-340-g001.jpg
case_images: PMC10559485_01_SNI-14-340-g001.jpg
case_images: F1
case_images: The postoperative abdominal X-ray confirmed that the shunt catheter was placed in the peritoneal cavity [Figure 1a]. Six months after VPS, an abdominal computed tomography was performed as a follow-up of colorectal cancer surgery and showed that the peritoneal catheter had migrated to the thoracic cavity [Figures 1b and c]. The patient did not experience subjective symptoms, but a small amount of pleural effusion was observed [Figure 1c]. It was confirmed that the shunt catheter had passed over the clavicle before penetrating the thoracic wall through the intercostal space between ribs 1 and 2 and entering the thoracic cavity [Figures 1d and e].