Tension hydrothorax due to delayed and spontaneous supradiaphragmatic and intrathoracic migration of ventriculoperitoneal shunt catheter in pediatric patient: a rare complication with exhaustive literature review.

Ventriculoperitoneal shunt (VPS) remains the gold standard for treating congenital and acquired hydrocephalus in children. Mechanical shunt failures and infections are the most frequent complications of this therapy. Intrathoracic complications, including shunt migration and pleural effusion causing hydrothorax, have been rarely reported. Here, the authors report a new rare case of spontaneous delayed supradiaphragmatic intrathoracic migration of a VPS catheter causing tension hydrothorax in a 9-year-old female patient treated with a VPS. She presented 45 months later for severe respiratory distress. The child underwent pleural drainage and VPS revision, with good outcomes. The authors will review the literature comprehensively and exhaustively to dissect this rare complication in the pediatric population.