Ventriculoperitoneal shunt migration with vaginal extrusion via the fallopian tube

Ventriculoperitoneal shunt (VPS) malfunctions are not uncommon and can lead to complex malfunctions including worsening hydrocephalus and organ injury through migration and perforation. We report a unique case of a VPS migrating through the fallopian tube, uterus, cervix and vagina of a 6-year-old female without organ perforation. X-ray demonstrated a coiled VP catheter exiting the pelvis and point of care ultrasound showed a hyperechoic structure traversing a distended fluid filled uterus. Diagnostic laparoscopy confirmed the path of shunt migration. •Ventriculoperitoneal shunt migration through the fallopian tube is rare.•A distended uterus is difficult to discern from the bladder on bedside ultrasound.•Treatment involves empiric antibiotics for potential CSF infection.•Management involves a coordinated surgical and neurosurgical approach.