Migration of the distal ventriculoperitoneal shunt catheter into the stomach with or without trans-oral extrusion: A systematic literature review and meta-analysis

Table 1 Demographics, clinical features, and outcome of the surgical procedures performed for the migration of the distal ventriculoperitoneal shunt catheter into the stomach with trans-oral extrusion (n = 32)

Ref.	Indication for VPS insertion	Age VPS insertion sex	Age trans-oral extrusion	Interval (mo)	VPS (R)	History GI Surg	Shunt tract infection	Peritonitis meningitis	CSF infection	Operative procedures executed	1Site repaired (Yes/No)	Complication	Outcome
Griffith et al[17], 1987	Hydrocephalus (Post infective)	9.6 yr Female	9.9 yr	3	Yes	Yes	No	No	No	Part of distal VPS catheter cut by child, proximal VPS catheter as EVD, delayed ventriculo-atrial shunt done	Stomach (No)	Yes	Death
Danismend et al[18], 1988	Hydrocephalus (Congenital?)	8 mo Female	18 mo	10	No	No	No	No	No	Removal of distal VPS catheter and Immediate ventriculo-atrial shunt done	Stomach (Yes)	Nil	R
Park et al[19], 2000	Hydrocephalus	12 mo female	5 yr	48	No	No	Yes	No	No	Removal of part of distal VPS catheter, Proximal VPS catheter as EVD, Delayed re-VPS/VPS (R) done	Stomach (No)	Nil	R
	(Post-haemorrhagic)
Jiménez Moya et al[20], 2001	Hydrocephalus (Brain tumor)	9.11 yr female	11.2 yr	2	Yes	Yes	No	No	No	Removal of entire VPS catheter, Delayed re-VPS insertion done	Stomach (NA)	Nil	R
Kothari et al[21], 2006	Hydrocephalus (Congenital)	1 mo male	18 mo	17	No	No	No	No	Yes	Removal of entire VPS catheter, Delayed re-VPS insertion done	Stomach? (No)	Nil	R
Odebode et al[22], 2007	Hydrocephalus (Congenital?)	9 mo female	15 mo	6	No	No	Yes	No	No	Removal of entire VPS catheter, Delayed re-VPS insertion done	Jejunum (Yes)	Nil	R
Berhouma et al[23], 2008	Hydrocephalus with NTD (Congenital)	9 mo male	2 yr	15	No	No	No	No	Yes	Removal of part of distal VPS catheter, Proximal VPS catheter as EVD	NA (No)	Yes	Death
Murali et al[24], 2008	Hydrocephalus (Congenital)	6 mo male	6 yr	66	No	No	No	No	No	Removal of part of distal VPS catheter, Proximal VPS catheter as EVD, Removal of cranial catheter failed	Stomach (No)	Nil	R
Sridhar et al[25], 2009	Hydrocephalus (Post infective)	2 mo female	8 mo	6	No	No	No	No	No	Removal of entire VPS catheter (re-VPS catheter insertion not required)	Stomach? (No)	Nil	R
Sinnadurai et al[26], 2009	Hydrocephalus (Cyst)	12 yr female	27 yr	2 wk	Yes	No	No	No	No	Removal of part of distal VPS catheter, Proximal VPS catheter as EVD, Delayed VPS (R) done	Stomach (No)	Nil	R
Low et al[27], 2010	Hydrocephalus (Post infective)	6 mo male	12 mo	6	No	Yes	No	No	No	Removal of entire VPS catheter, Insertion of EVD, Delayed re-VPS insertion done	Stomach (No)	Nil	R
Dua et al[28], 2011	Hydrocephalus with NTD (Congenital)	20 d male	8 mo	7	No	No	No	No	No	Removal of part of distal VPS catheter, Proximal VPS catheter as EVD, Delayed re-VPS insertion done	Stomach (No)	Nil	R
Agarwal et al[29], 2011	Hydrocephalus (Congenital)	4 mo male	12 mo	8	No	No	No	No	No	Removal of entire VPS catheter, Delayed re-VPS insertion done	NA (No)	Nil	R
Gupta et al[30], 2012	Hydrocephalus (Congenital)	6 mo male	4 yr	42	No	No	No	No	No	Removal of entire VPS catheter (re-VPS insertion not required)	Stomach (No)	Nil	R
Kundal et al[31], 2012	Hydrocephalus (Post infective)	6 yr male	7 yr	12	No	No	No	No	No	Removal of entire VPS catheter, Delayed re-VPS insertion done	NA (No)	Nil	R
Yilmaz et al[32], 2013	Hydrocephalus (Pseudotumor)	37 yr female	47 yr	120	No	Yes	No	No	No	Removal of entire VPS catheter (re-VPS insertion not required)	Stomach (Yes)	Nil	R
Gupta et al[33], 2014	Hydrocephalus (Congenital)	12 mo male	11 yr	7	Yes	No	No	No	No	Removal of entire VPS catheter (Previous VPS functioning well)	Stomach (No)	Nil	R
Mandhan et al[34], 2015	Hydrocephalus with NTD (Congenital)	Infant female	11 yr	53	No	Yes	No	No	No	Removal of entire VPS catheter (re-VPS insertion not done/required?)	Stomach (No)	Nil	R
Thiong’o et al[35], 2015	Hydrocephalus (Congenital)	10 d female	3 mo	2	No	No	No	No	No	Removal of entire VPS catheter, Insertion of EVD, Delayed re-VPS insertion done	Stomach? (No)	Nil	R
Sohal et al[36], 2015	Hydrocephalus (Congenital?)	NA male	11 mo	10 d	Yes	Yes	No	No	No	Removal of part of distal VPS catheter, Proximal VPS catheter as EVD, Delayed ventriculo-atrial shunt done	Stomach (No)	Nil	R
Ghritlaharey et al[37], 2015	Hydrocephalus (Post infective/Congenital)	12 mo female	24 mo	9	Yes	No	No	No	No	Removal of part of distal VPS catheter, Proximal VPS catheter as EVD, Delayed VPS (R) done	Stomach? (No)	Yes	R
Shahet al[38], 2016	Hydrocephalus (Congenital)	12 mo male	4 yr	12	Yes	No	No	No	No	Removal of entire VPS catheter (re-VPS insertion not required)	Stomach (No)	Nil	R
Sharmaet al[39], 2017	Hydrocephalus (Congenital)	Neonate male	8 mo	7	No	No	No	No	No	Removal and re-positioning of distal VPS catheter into the peritoneal cavity	Stomach (No)	Nil	R
Al Fauzi Aet al[40], 2017	Hydrocephalus (Brain tumor)	4 yr male	5 yr	12	No	No	No	No	No	Removal of entire VPS catheter (re-VPS insertion not required)	Stomach (No)	Nil	R
Reyeset al[41], 2017	Hydrocephalus (Post-haemorrhagic)	2 mo male	16 mo	8	Yes	No	No	No	No	Removal of entire VPS catheter, Immediate re-VPS insertion done	Stomach (No)	Nil	R
Badriet al[42], 2018	Hydrocephalus (Congenital)	4 yr male	4 yr	1	No	No	No	No	No	Removal of distal VPS catheter, Immediate VPS (R) done	Duodenum (Yes)	Nil	R
Romualdet al[43], 2018	Hydrocephalus (Congenital)	24 mo male	34 mo	10	No	No	No	No	Yes	Removal of entire VPS catheter, Insertion of EVD, Delayed re-VPS insertion done	Duodenum (Yes)	Nil	R
Ezzatet al[44], 2018	Hydrocephalus (Congenital)	2 mo male	22 mo	20	No	No	No	No	No	Removal of entire VPS catheter, Cranial catheter as EVD? Delayed re-VPS insertion done	Stomach? (No)	Nil	R
Bemoraet al[45], 2019	Hydrocephalus (Post infective)	7 mo female	16 mo	9	No	No	No	No	NA	Removal of entire VPS catheter, Immediate re-VPS insertion done	Stomach (No?)	Nil	R
Feeneyet al[46], 2020	Hydrocephalus (Post trauma)	57 yr male	58 yr	11	No	No	No	No	Yes	Removal of distal VPS catheter, Proximal VPS catheter as EVD, Removal of proximal VPS catheter (re-VPS insertion not required)	Jejunum (No)	Nil	R
Calgaroet al[47], 2020	Hydrocephalus (Congenital)	2 mo male	7 mo	5	No	No	No	No	NA	Removal of entire VPS catheter, Immediate re-VPS insertion done	Stomach? (No)	Nil	R?
Najibet al[48], 2022	Hydrocephalus with NTD (Congenital)	Neonate male	8 mo	7	No	No	No	No	No	Removal of part of distal VPS catheter and re-positioning of remaining distal catheter into the peritoneal cavity	Stomach (Yes)	Nil	R

¹Site: Site of perforation.

CSF: Cerebrospinal fluid; EVD: External ventricular drainage; GI Surg: Gastrointestinal/abdominal surgery; NA: Not available/details not available; NTD: Neural tube defect; R: Recovered; VPS: Ventriculoperitoneal Shunt; VPS (R): Ventriculoperitoneal Shunt revision.