Constipation as a reversible cause of ventriculoperitoneal shunt failure

Report of two cases

Restricted access

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

✓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.

Abbreviations used in this paper:CSF = cerebrospinal fluid; CT = computed tomography; VP = ventriculoperitoneal.
Article Information

Contributor Notes

Address reprint requests to: Herbert E. Fuchs, M.D., Ph.D., Division of Neurosurgery, Duke University Medical Center, Box 3807, Durham, North Carolina 27710. email:
  • 1

    Amacher ALWellington J: Infantile hydrocephalus: long-term results of surgical therapy. Childs Brain 11:2172291984

  • 2

    Bragg CLEdwards-Beckett JEckle NPrincipe KTerry D: Shunt dysfunction and constipation: could there be a link?. J Neurosci Nurs 26:91941994

    • Search Google Scholar
    • Export Citation
  • 3

    Bragg CLEdwards-Beckett JEckle NPrincipe KTerry D: Ventriculoperitoneal shunt dysfunction and constipation: a chart review. J Neurosci Nurs 26:2652691994

    • Search Google Scholar
    • Export Citation
  • 4

    Cozzens JWChandler JP: Increased risk of distal ventriculoperitoneal shunt obstruction associated with slit valves or distal slits in the peritoneal catheter. J Neurosurg 87:6826861997

    • Search Google Scholar
    • Export Citation
  • 5

    Del Bigio MR: Epidemiology and direct economic impact of hydrocephalus: a community based study. Can J Neurol Sci 25:1231261998

  • 6

    Kestle JRDrake JMCochrane DDMilner RWalker MLAbbott R III: Lack of benefit of endoscopic ventriculoperitoneal shunt insertion: a multicenter randomized trial. J Neurosurg 98:2842902003

    • Search Google Scholar
    • Export Citation
  • 7

    Lambert DMMarceau SForse RA: Intra-abdominal pressure in the morbidly obese. Obes Surg 15:122512322005

  • 8

    Lemire RJ: Neural tube defects. JAMA 259:5585621988

  • 9

    McGirt MJLeveque JCWellons JC IIIVillavicencio ATHopkins JSFuchs HE: Cerebrospinal fluid shunt survival and etiology of failures: a seven-year institutional experience. Pediatr Neurosurg 36:2482552002

    • Search Google Scholar
    • Export Citation
  • 10

    Rotim KMiklic PPaladino JMelada AMarckic MScap M: Reducing the incidence of infection in pediatric cerebrospinal fluid shunt operations. Childs Nerv Syst 13:5845871997

    • Search Google Scholar
    • Export Citation
  • 11

    Sainte-Rose C: Shunt obstruction: a preventable complication?. Pediatr Neurosurg 19:1561641993

  • 12

    Sainte-Rose CPiatt JHRenier DPierre-Kahn AHirsch JFHoffman HJ: Mechanical complications in shunts. Pediatr Neurosurg 17:291991

    • Search Google Scholar
    • Export Citation
  • 13

    Vinchon MFichten ADelestret IDhellemmes P: Shunt revision for asymptomatic failure: surgical and clinical results. Neurosurgery 52:3473562003

    • Search Google Scholar
    • Export Citation
  • 14

    Wisoff JHKratzert KJHandwerker SMYoung BKEpstein F: Pregnancy in patients with cerebrospinal fluid shunts: report of a series and review of the literature. Neurosurgery 29:8278311991

    • Search Google Scholar
    • Export Citation


All Time Past Year Past 30 Days
Abstract Views 501 357 12
Full Text Views 58 15 4
PDF Downloads 219 15 5
EPUB Downloads 0 0 0
Google Scholar