Affiliations: Department of Surgery, College of Medicine, King Saud
University, Riyadh, Saudi Arabia | Department of Pediatrics, College of Medicine, King
Saud University, Riyadh, Saudi Arabia
Note:  Correspondence: Dr. Essam A. Elgamal, Division of Neurosurgery,
Department of Surgery, College of Medicine, King Saud University, P.O. Box
7805, Riyadh 11472, Saudi Arabia. Tel.: +966 1 4671273; Fax: +966 1 4679493;
E-mail: [email protected]
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.