Acute abdomen in children with infected ventriculoperitoneal shunts

During the past 48 months, seven children with infected ventriculoperitoneal shunts with acute abdominal emergencies in the absence of neurological signs or symptoms were encountered. Initial confusion in the correct diagnosis led to unnecessary laparatomy in three children and a dangerous delay in the initiation of appropriate treatment in all seven patients. The correct diagnosis was made by analysis of ventricular fluid obtained from the shunt reservoir. Diversion of infected CSF from the inflamed peritoneal cavity combined with intravenous and intraventricular antibiotics resulted in prompt resolution of abdominal signs and successful sterilization of the CSF. Total shunt replacement in uncontaminated CSF followed by postoperative antibiotic therapy administered intravenously effected complete cures in all patients. Awareness of this syndrome and its proper management is of paramount importance.