Constipation as a reversible cause of ventriculoperitoneal shunt failure. Report of two cases

Ciaran J Powers1, Timothy George, Herbert E Fuchs

  • 1Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.

Journal of Neurosurgery
|September 15, 2006
PubMed

Insights

Ventriculoperitoneal (VP) shunt failure in children can be caused by chronic constipation. Treating constipation resolved shunt issues in two pediatric cases, suggesting a link between intraabdominal pressure and VP shunt obstruction.

Area of Science:

  • Pediatric Neurosurgery
  • Gastroenterology

Background:

  • Ventriculoperitoneal (VP) shunts are crucial for treating hydrocephalus in children.
  • Shunt failure, often due to obstruction, is a frequent complication requiring surgical intervention.

Observation:

  • Elevated intraabdominal pressure is a known risk factor for VP shunt failure.
  • Chronic constipation can lead to sustained increases in intraabdominal pressure.

Findings:

  • Two pediatric cases presented with VP shunt failure and severe constipation.
  • Resolution of constipation led to documented improvement in VP shunt function in both cases.

Implications:

  • Chronic constipation may be an underrecognized cause of distal VP shunt failure in children.
  • Addressing constipation could be a vital, non-surgical approach to managing certain VP shunt failures.

Related Concept Videos

Intestinal Obstruction II: Pathophysiology01:07

Intestinal Obstruction II: Pathophysiology

Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
Diverticular Disease of the Colon01:27

Diverticular Disease of the Colon

Diverticular disease involves the formation of diverticula—small sac-like outpouchings of the colonic wall—and their complications. It most commonly affects the sigmoid colon due to higher intraluminal pressure and structural vulnerability. It results from structural weakness and increased pressure in the colon, producing pseudodiverticula that may remain silent or progress to inflammation and serious complications.Structure of DiverticulaIn diverticulosis, these outpouchings are...
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
Intestinal Obstruction I: Introduction01:29

Intestinal Obstruction I: Introduction

Intestinal obstruction is a partial or complete blockage of the small or large intestine that disrupts the normal flow of intestinal contents through the lumen. This interruption impairs digestion, absorption, and fluid balance, and may lead to serious complications if not treated promptly.Mechanical ObstructionMechanical obstruction occurs when a physical blockage prevents intestinal contents from passing, arising from within the lumen or the bowel wall, or from external compression.Adhesions,...
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...