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Click EXAM: CT abdomen and pelvis without contrast (DATE: 6/2004)

HISTORY: 20-year-old male with a history of cerebral palsy, hydrocephalus, and 2 prior VP shunt placements.
TECHNIQUE: Multiple CT axial images (5 mm) were obtained from the level of the diaphragm through the pubic symphysis. (GE Lightspeed 16 slice, protocol: 399 mAs, 120 kVp).
FINDINGS:
There is an abandoned, disconnected ventriculoperitoneal shunt catheter that extends within the soft tissues of the anterior right hemithorax and terminates in the anterior subcutaneous soft tissues of the right upper abdomen.
An abandoned, disconnected ventriculoperitoneal shunt catheter is identified extending horizontally within the upper abdomen. The catheter traversing superior and anterior to the gastric body, between the gastric antrum and inferior liver, and is coiled in the right upper abdominal quadrant. The terminal tip of catheter is seen within the peritoneal cavity adjacent to the inferior segment of the right hepatic lobe and hepatic flexure of the colon. The abandoned VP shunt does not perforate the gastric lumen, liver, or colon as seen on future exams.


Click CT chest with contrast (DATE: 11/2006)
HISTORY: 28-year-old male with a history of cerebral palsy, hydrocephalus, and 2 prior VP shunt placements.
TECHNIQUE: Reconstructed coronal images from a CT chest with contrast (150 ml of IV Optiray 350) are also presented for comparison (GE 64 slice, protocol: 335 mAs, 140 kVp, 1.25 mm).

FINDINGS:
There is opacification at the lung bases, left greater than right.
There is an abandoned, disconnected ventriculoperitoneal shunt catheter that extends within the soft tissues of the anterior right hemithorax and terminates in the anterior subcutaneous soft tissues of the right upper abdomen.
A non-abandoned ventriculoperitoneal shunt catheter is present within the anterior soft tissues of the right chest to the right lower abdomen and extends through the abdominal wall terminating in the right lower quadrant peritoneal cavity. Stranding within the anterior subcutaneous fat in the right lower abdominal quadrant is likely post-surgical in etiology.
An abandoned, disconnected ventriculoperitoneal shunt catheter is identified extending horizontally within the upper abdomin. The catheter does not perforate the gastric lumen. The catheter is coiled in the right upper abdominal quadrant in close approximation with the liver and colon. The catheter terminates just inside the wall of the hepatic flexure of the colon.


Click CT abdomen and pelvis with contrast (DATE: 12/2006)
HISTORY: 28-year-old male with a history of cerebral palsy, hydrocephalus, and 2 prior VP shunt placements.
TECHNIQUE: Multiple CT axial images (4 mm) were obtained on 12/2006 from the level of the diaphragm through the pubic symphysis after the uneventful, intravenous administration of 125 ml of Optiray- 350. Oral contrast was administered (Siemens 64 slice, protocol: 321 mAs, 120 kVp).

FINDINGS:
An abandoned, disconnected ventriculoperitoneal shunt catheter is identified extending horizontally within the upper abdomen. The catheter does not perforate the gastric lumen. The catheter is coiled in the right upper abdominal quadrant in close approximation with the liver and colon. The catheter terminates just inside the wall of the hepatic flexure of the colon. Coronal images from the CT chest obtained 11/2006 shows the abandoned catheter coiled in the right upper abdomen quadrant, outside the liver parenchyma and gastric lumen.
A percutaneous gastrostomy tube is again noted. Multiple calculi and a Foley catheter within the urinary bladder are present. A right femoral artery catheter terminates in the external iliac artery.


Click EXAM: CT abdomen and pelvis without contrast (DATE: 1/2012)

HISTORY: 28-year-old male with a history of cerebral palsy, hydrocephalus, and 2 prior VP shunt placements presents with urolithiasis.
TECHNIQUE: Multiple CT axial images (5 mm) were obtained from the level of the diaphragm through the pubic symphysis.
FINDINGS:
There is left greater than right bibasilar airspace disease with air bronchograms, which could represent a combination of atelectasis and/or pneumonia.
There is an abandoned, disconnected ventriculoperitoneal shunt catheter that extends within the soft tissues of the anterior right hemithorax and terminates in the anterior subcutaneous soft tissues of the right upper abdomen.
A non-abandoned ventriculoperitoneal shunt catheter is present within the anterior soft tissues of the right chest to the right lower abdomen and extends through the abdominal wall terminating in the right lower quadrant peritoneal cavity.
An abandoned, disconnected ventriculoperitoneal shunt catheter is identified extending horizontally within the upper abdomen. A small amount of fluid is present around the tip of the VP shunt within the left upper abdomen between the spleen and diaphragm. The abandoned VP shunt perforates the gastric lumen at the superior wall of the pylroic antrum and exits the lumen near the junction of the stomach and duodenum. The next segment of this catheter is coiled in the right upper abdominal quadrant where it perforates the inferior portion of the right hepatic lobe and terminates within the hepatic flexure of the colon.
Renal stones are seen bilaterally, most significant within a within a lower pole calyx in the left kidney measuring up to 3 mm. No hydronephrosis or hydroureter.

Multiple layering bladder calculi are present. There is also a calcification projecting outside the lumen of the bladder which is medial to the insertion of the right
ureterovesicular junction, which may represent calcification within a diverticulum.


Click EXAM: CT abdomen and pelvis without contrast (DATE: 1/2012)

HISTORY: 28-year-old male with a history of cerebral palsy, hydrocephalus, and 2 prior VP shunt placements presents with urolithiasis.
TECHNIQUE: Reformatted coronal images (2 mm) were obtained from axial CT images (5 mm) which were obtained from the level of the diaphragm through the pubic symphysis. (Siemens 64 slice, protocol: 200 mAs, 120 kVp).
FINDINGS:
There is left greater than right bibasilar airspace disease with air bronchograms, which could represent a combination of atelectasis and/or pneumonia.
There is an abandoned, disconnected ventriculoperitoneal shunt catheter that extends within the soft tissues of the anterior right hemithorax and terminates in the anterior subcutaneous soft tissues of the right upper abdomen.
A non-abandoned ventriculoperitoneal shunt catheter is present within the anterior soft tissues of the right chest to the right lower abdomen and extends through the abdominal wall terminating in the right lower quadrant peritoneal cavity.
An abandoned, disconnected ventriculoperitoneal shunt catheter is identified extending horizontally within the upper abdomen. A small amount of fluid is present around the tip of the VP shunt within the left upper abdomen between the spleen and diaphragm. The abandoned VP shunt perforates the gastric lumen at the superior wall of the pylroic antrum and exits the lumen near the junction of the stomach and duodenum. The next segment of this catheter is coiled in the right upper abdominal quadrant where it perforates the inferior portion of the right hepatic lobe and terminates within the hepatic flexure of the colon.
Renal stones are seen bilaterally, most significant within a within a lower pole calyx in the left kidney measuring up to 3 mm. No hydronephrosis or hydroureter.

Multiple layering bladder calculi are present. There is also a calcification projecting outside the lumen of the bladder which is medial to the insertion of the right
ureterovesicular junction, which may represent calcification within a diverticulum.