Repeated cannulation of umbilical hernia with Ventriculoperiotoneal shunt catheter

Ventriculoperitoneal (VP) shunts are commonly used to manage hydrocephalus in both adult and paediatric populations. Whilst infection remains by far the most common complication leading to shunt revision other causes need to be considered. Our case report examines a 62-year-old female who presents for operative management of a Choroid Plexus Papilloma. Post-operatively she develops hydrocephalus and is managed with a VP shunt. Interestingly the distal end of the catheter cannulated an unknown umbilical hernia twice creating diagnostic dilemma. Issues around shunt insertion in the morbidly obese population and the basic science behind cerebrospinal fluid reabsorption are explored. Although this is a rare complication it should be considered in any post-operative shunt patient is slow to recover particularly if they are obese.