Fractured and Migrated Ventriculoperitoneal Shunt into the Urinary Bladder: A Case Report

Ventriculoperitoneal Shunting (VPS) is a standard and widely performed surgical treatment for hydrocephalus; however, distal shunt-related complications such as obstruction, infection, disconnection, and migration may occur. Fracture and migration of the distal catheter into hollow viscera has been documented, but bladder perforation with intravesical migration of shunt remains an exceptionally rare late complication. We report a 55-year-old woman with bilateral VPS placed for recurrent third ventricular colloid cyst who presented with extrusion of a shunt fragment through the urethra one week before outpatient visit, associated with abdominal pain, burning micturition, and fever. Ultrasonography and Contrast-Enhanced Computed Tomography (CECT) of the abdomen revealed a fractured distal catheter with intravesical migration and a localised collection near the bladder dome. Cystourethroscopy confirmed a coiled shunt within the urinary bladder. The intravesical segment was successfully removed endoscopically under local anaesthesia while preserving the cranial component. The patient recovered uneventfully. Early recognition and minimally invasive management can result in favourable outcomes for this rare but potentially serious complication.