Retained peritoneal shunt tubing causing hematuria

This 14-year-old boy with congenital hydrocephalus underwent initial shunt placement shortly after birth. During his first 6 years of life, multiple ventriculoperitoneal (VP) shunt revisions were performed to address seven shunt malfunctions and one shunt infection (Staphylococcus epidermidis). During the last shunt revision, which took place 8 years before the current presentation, it was noted that the distal peritoneal shunt tubing (Peritoneal Catheter, Standard, Barium Impregnated; Medtronic Inc., Minneapolis, MN) had fractured and was coiled in the pelvis. Nevertheless, the tubing was not retrieved at that time.