THREE-DIMENSIONAL COMPUTED TOMOGRAPHY (3D-CT) AS A GUIDE TO A REMOVAL OF INTRAPERITONEAL FOREIGN BODY

This paper demonstrates the usefulness of three-dimensional computed tomography (3D-CT) in visualizing a ventriculoperitoneal (V-P) shunt, which aberrantly entered into the abdomen and might cause abdominal pain, to facilitate the removal of the shunt. A 59-year-old man underwent clipping of a cerebral aneurysm and insertion of a V-P shunt catheter on February 25, 1989. Two years later, another V-P shunt catheter had to be inserted because of failure of the former one. On May 31, 1992, he developed pain in his right lower abdomen, and examinations revealed local peritonitis. An abdominal X-ray film demonstrated an older V-P shunt catheter remaining in his abdomen, and it was thought to be the focus of infection. 3D-CT scans elucidated how the older and newer V-P shunt catheters were traveling in his abdomen and how we could reach them. We performed simulation surgery on 3D-CT preoperatively, and it allowed us to make the most appropriate skin incision to remove the former catheter.