Bowel perforation as a late complication of pleuroperitoneal shunt

A 33-year-old female patient, who is an occasional smoker and was diagnosed with pulmonary lymphangioleiomyomatosis three years ago, had a pleuroperitoneal shunt implanted after presenting with a secondary chylothorax that failed to respond to medical–surgical treatment. During follow-up, the patient remained clinically asymptomatic with a normally functioning pleuroperitoneal shunt. However, a routine thoracoabdominal CT scan revealed that the abdominal portion of the drain had entered an intestinal loop (Figure 1). As a result, the patient was referred to our service for further evaluation.

It was determined that the catheter had penetrated the free colonic loop, and the catheter was surgically removed. The patient recovered well and was asymptomatic with no evidence of recurrence of pleural effusion at the six-month follow-up. This case highlights that although pleuroperitoneal shunting is an available therapeutic alternative for secondary chylothorax, its potential complications after prolonged use should not be underestimated.

Figure 1.

The format is Cardiothoracic Imagen.

Author’s contribution

All authors have contributed significantly to the content of the article.