PMC7266963_01
The distal catheter extruded from the umbilicus after VPS.
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F1
The shunt catheter subsequently extruded through the fistula for about 25 cm length (Figure 1).
Abdominal axial CT (left) showing that there is fluid around the shunt at the superficial part of the abdomen around the umbilicus. CT (right) demonstrating that the shunt catheter was extruded through the umbilicus.
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F2
Abdominal CT scan revealed that the effusion was encapsulated and localized around the umbilicus (Figure 2).
Abdominal CT revealing that the effusion disappeared.
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F3
Three months later, an abdominal CT revealed that the effusion had disappeared (Figure 3).
Extensive organ adhesions in the abdomen, including the digestive tract, greater omentum, and peritoneum, were visible.
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F4
Connective tissue proliferation was also found to form a granular mass enclosing the fistula and catheter (Figure 4).
The extrusive part of the shunt was cut off, and the intra-abdominal part was repositioned on the diaphragm-facing surface of the liver using the laparoscope.
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F5
Finally, the extrusive part of the shunt was cut off and the intra-abdominal part was repositioned on the diaphragm-facing surface of the liver after ensuring its patency, observing CSF dripping from its distal end (Figure 5).