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To THE EDITOR: We appreciated the article by Morais et al.2 describing a 6-year-old shunt-treated spina bifida patient in the emergency department, presenting with mixed symptoms of shunt malfunction and abdominal pathology (Morais BA, Cardeal DD, Andrade FG, et al: Reversible ventriculoperitoneal shunt dysfunction and chronic constipation: case report. J Neurosurg Pediatr 22:147–150, August 2018). The authors demonstrate concomitant ventricular dilatation and abdominal constipation, which resolved with nonsurgical management. The discussion included the possibility that intracranial hypertension could cause bowel dysfunction. At our institution, we frequently observe the clinical phenomenon of transient shunt malfunction