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Updated: Jul 20, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
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.
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.
Abstract:
Ventriculoperitoneal (VP) shunt failure is a common problem encountered by pediatric neurosurgeons. The majority of such failures are due to obstruction of the device. Conditions in which intraabdominal pressure is chronically elevated, such as pregnancy, have been associated with shunt failure. Chronic constipation may also result in abnormally elevated intraabdominal pressure and may be an underrecognized cause of distal VP shunt failure. The authors describe the cases of two children who presented with clinical and imaging evidence of VP shunt failure and who were also severely constipated. Treatment of their constipation resulted in both clinical and imaging-documented resolution of their shunt failure.
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