Ventriculoperitoneal shunt failure due to raised intra-abdominal pressure: A case report and review of the literature

Abstract

Background: Ventriculoperitoneal (VP) shunt implantation is the standard neurosurgical procedure to treat hydrocephalus for various reasons. Its function depends on the differential pressure between the ventricular space and the peritoneal cavity. Correct functioning of cerebrospinal fluid (CSF) valves requires a gradient of pressure between the ventricular and the abdominal cavity. Any reason that disrupts this balance can result in dysfunction of the system. Increased intra-abdominal pressure (IAP) may be a reason to induce shunt failure by decreasing CSF drainage from the ventricular system to the peritoneal cavity. Case Description: We report a case of repeated VP shunt failure because of constipation and successful conservative management by lowering IAP without surgical revision of the VP shunt system and reviewed the relevant literature. Conclusion: Increased IAP for a variety of reason should always be considered as a possible reason for shunt failure that can often be treated conservatively and therefore can reduce unnecessary shunt revision surgery.