Constipation as a reversible cause of ventriculoperitoneal shunt failure

Report of two cases

Ciaran J. Powers M.D., Ph.D., Timothy George M.D. and Herbert E. Fuchs M.D., Ph.D.
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  • Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina

✓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.

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: Fuchs001@mc.duke.edu.
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