Expanding the differential diagnosis of the acute scrotum: ventriculoperitoneal shunt herniation.

An 18-month-old boy presented to the emergency department after 4 hours of inconsolability and acute scrotal swelling. The physical examination revealed a new scrotal hydrocele with migration of a ventriculoperitoneal shunt into the right hemiscrotum. The presence of a ventriculoperitoneal shunt has been associated with increased patency of the processus vaginalis and scrotal hydroceles. The presentation of an acute scrotum in a child with a ventriculoperitoneal shunt should be recognized as a possible shunt complication. Migration of the shunt through the processus vaginalis is an extremely uncommon event.