Tension pneumothorax – a rare complication of ventriculoperitoneal shunt

Abstract

Background Ventriculoperitoneal shunt placement is a standard treatment for hydrocephalus. Common complications include shunt infection, obstruction, malfunction and abdominal complications. Thoracic complications, however, are rare. Observations We report on a five-year-old Mauritian child with cerebral palsy, who developed a rare complication of recurrent right-sided tension pneumothorax after insertion of a ventriculoperitoneal shunt for hydrocephalus. A contrast study revealed a fistulous connection between the shunt and the bronchial tree. Insertion of a chest tube and subsequent repositioning of the shunt showed rapid improvement of her signs and symptoms. Lessons Recurrent tension pneumothorax from bronchopleural fistula following migration of the shunt from the abdomen into the chest via the diaphragm is a rare thoracic complication of ventriculoperitoneal shunt, for which shunt repositioning should be urgently undertaken. The report demonstrates how to evaluate such a case with minimal resources.