Management of Unusual Ventriculoperitoneal Shunt Complications

Objectives: Ventriculoperitoneal shunt surgery is the most widely used procedure in the treatment of hydrocephalus. However, this procedure has been associated with several delayed unusual complications. This paper will discuss these cases, their management and suggest ways on how to avoid these complications. Methods: This prospective study was conducted in the neurosurgery unit at King Hussein Medical Centre, and included the patients between January 1996 July 2007. The patients’ images and management were reviewed. Results: Sixteen patients were included in the study (10 males and 6 females). Their age was between three months and 40 years. One case had rectal perforation by ventriculoperitoneal shunt, seven cases had intraventricular migration of ventriculoperitoneal shunt, one case had umbilical perforation, one case had chest wall perforation by ventriculoperitoneal shunt, one case had liver perforation, four cases had overdrainage with subdural hematoma, one case had bladder perforation and one case had colon perforation by a ventriculoperitoneal shunt resulting in pneumocephalus. The management of ventriculoperitoneal shunt complications is discussed in details in this study. Conclusions: The information provided within this study provides an analysis of our cases and the literature as it relates to the unusual complication of ventriculoperitoneal shunt through symptomatic presentation, diagnosis and management of these cases.