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Updated: Nov 11, 2025
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Abdominal complications in patients with a ventriculoperitoneal shunt: proposal for management recommendations from a
Yamila Nadia Itati Basilotta Márquez1, Juan Pablo Mengide2, Juan Manuel Liñares1
1Neurosurgery Department, Garrahan Hospital, Buenos Aires, Argentina.
Insights
Ventriculoperitoneal shunt complications require tailored surgical management based on symptom severity and infection status. Treatment recommendations focus on individualized approaches for abdominal pseudocysts, bowel issues, and ascites.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Gastroenterology
Background:
- Ventriculoperitoneal shunts are crucial for hydrocephalus management.
- Shunt-related abdominal complications pose significant clinical challenges.
- Complications include abdominal pseudocyst, bowel issues, and ascites.
Purpose of the Study:
- To describe experience managing ventriculoperitoneal shunt-related abdominal complications.
- To propose evidence-based treatment recommendations for these complications.
Main Methods:
- Retrospective descriptive study of 48 pediatric patients (2009-2019).
- Classification into abdominal pseudocyst, bowel complications, and ascites groups.
- Analysis of clinical presentation, diagnostic imaging, and surgical interventions.
Main Results:
- Surgical decisions guided by symptom severity, ventricular enlargement, and CSF culture results.
- Infection presence led to shunt removal and external ventricular drain placement.
- Oligosymptomatic patients' management depended on awaiting culture results.
Conclusions:
- Surgical management of shunt-related abdominal issues is individualized.
- Treatment hinges on symptom severity and presence of infection.
- Tailored approaches optimize outcomes for pediatric patients.
Purpose:
The aim of this study was to describe our experience in the management of patients with ventriculoperitoneal shunt-related complications (abdominal pseudocyst, bowel-related complications, and ascites) and to propose treatment recommendations.
Material And Methods:
A retrospective descriptive study was conducted in patients with ventriculoperitoneal shunt-related abdominal complications seen between 2009 and 2019 at a tertiary-care pediatric center. Patients were classified according to their diagnosis into the following: group A (abdominal pseudocyst), group B (bowel-related complications), and group C (ascites). The following variables were studied in all three groups: age, sex, etiology of hydrocephalus, history of pyogenic ventriculitis, history of abdominal surgery, clinical presentation, presence of ventricular enlargement on computed tomography scan, abdominal ultrasonography, shunt series X-ray, cerebrospinal fluid cultures, urgent as well as elective surgical interventions, antibiotic treatment, length of hospital stay, follow-up, and outcome.
Results:
Overall, 48 patients were analyzed: group A, n=29; group B, n=15; and group C, n=4. In all cases, surgical decision-making was based on symptom severity at the time of diagnosis, presence of ventricular enlargement on computed tomography scan, and cerebrospinal fluid culture results. In patients with positive cultures, the shunt system was removed, and an external ventricular drain was placed. In oligosymptomatic patients, cerebrospinal fluid culture results were awaited to define long-term treatment and in patients with ventricular enlargement or clinically difficult-to-treat symptoms, the distal catheter was exteriorized at the thoracic level.
Conclusion:
In patients with shunt-related abdominal complications, surgical management depends on symptom severity and/or whether infection is present at the time of diagnosis.
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