ventriculoperitoneal shunt


Summary: Surgical creation of a communication between a cerebral ventricle and the peritoneum by means of a plastic tube to permit drainage of cerebrospinal fluid for relief of hydrocephalus. (From Dorland, 28th ed)

Top Publications

  1. Lee J, Seok J, Lee J, Choi E, Phi J, Kim S, et al. Incidence and risk factors of ventriculoperitoneal shunt infections in children: a study of 333 consecutive shunts in 6 years. J Korean Med Sci. 2012;27:1563-8 pubmed publisher
    ..aureus within two months after shunt surgery. Vancomycin may be considered as the preoperative prophylaxis for shunt surgery in a situation where methicillin resistance rate is very high. ..
  2. Berkmann S, Schreiber V, Khamis A. Recurrent intrahepatic dislocation of ventriculoperitoneal shunt. Minim Invasive Neurosurg. 2011;54:83-6 pubmed publisher
    ..Chronic infection as an underlying cause of peritoneal fibrosis has to be ruled out. ..
  3. Fathi A, Mariani L, Szucs Farkas Z, Exadaktylos A, Bonel H. Evaluation of the new Statscan radiography device for ventriculoperitoneal shunt assessment. AJR Am J Roentgenol. 2011;196:W285-9 pubmed publisher
    ..The Statscan digital x-ray machine allows accurate assessment of VP shunt continuity at lower radiation dosages and in less time than conventional x-ray techniques. ..
  4. Shafiee S, Nejat F, Raouf S, Mehdizadeh M, El Khashab M. Coiling and migration of peritoneal catheter into the breast: a very rare complication of ventriculoperitoneal shunt. Childs Nerv Syst. 2011;27:1499-501 pubmed publisher
    Upward migration of distal catheter of a ventriculoperitoneal shunt with coiling is very rare. Pseudocyst and galactorrhea are known breast-related complications...
  5. Shannon C, Simon T, Reed G, Franklin F, Kirby R, Kilgore M, et al. The economic impact of ventriculoperitoneal shunt failure. J Neurosurg Pediatr. 2011;8:593-9 pubmed publisher
    ..These resources and services could offset the out-of-pocket burden, and therefore should be considered in future cost models. ..
  6. Ghritlaharey R, Budhwani K, Shrivastava D, Srivastava J. Ventriculoperitoneal shunt complications needing shunt revision in children: a review of 5 years of experience with 48 revisions. Afr J Paediatr Surg. 2012;9:32-9 pubmed publisher
    ..64%) and following shunt revisions were 4 (10%). VP shunt done for hydrocephalus in children is not only prone for complications and need for revision surgery but also associated with considerable mortality. ..
  7. Yamada S, Kitagawa R, Teramoto A. Relationship of the location of the ventricular catheter tip and function of the ventriculoperitoneal shunt. J Clin Neurosci. 2013;20:99-101 pubmed publisher
    ..Early shunt revision may be required for patients in whom the catheter tip contacts the ventricle wall or is located in the septum pellucidum. ..
  8. Kita D, Hayashi Y, Kinoshita M, Ohama K, Hamada J. Scrotal migration of the peritoneal catheter of a ventriculoperitoneal shunt in a 5-year-old male. Case report. Neurol Med Chir (Tokyo). 2010;50:1122-5 pubmed
    A 5-year-old male presented with scrotal migration of the catheter from a ventriculoperitoneal shunt manifesting as left scrotal swelling 4 months after implantation...
  9. Pohlman G, Wilcox D, Hankinson T. Erosive bladder perforation as a complication of ventriculoperitoneal shunt with extrusion from the urethral meatus: case report and literature review. Pediatr Neurosurg. 2011;47:223-6 pubmed publisher
    ..The authors discuss other reported cases of perforation by a VP shunt, potential mechanisms, and considerations for management of this rare complication. ..

More Information


  1. Lee S, Kong D, Seol H, Nam D, Lee J. Ventriculoperitoneal shunt for hydrocephalus caused by central nervous system metastasis. J Neurooncol. 2011;104:545-51 pubmed publisher
    ..Hydrocephalus in CNS metastasis requiring VPS is commonly associated with LMS. VPS is an effective palliative measure and an adequate cancer treatment after VPS may provide the best means of improving survival. ..
  2. Shim K, Kim D, Choi J. Simultaneous endoscopic third ventriculostomy and ventriculoperitoneal shunt for infantile hydrocephalus. Childs Nerv Syst. 2008;24:443-51 pubmed
    We analyzed a series of consecutive hydrocephalic infants treated with implantation of a ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV) simultaneously...
  3. Elliott S, Yogev R, Shulman S. Staphylococcus lugdunensis: an emerging cause of ventriculoperitoneal shunt infections. Pediatr Neurosurg. 2001;35:128-30 pubmed
    ..We describe the first two pediatric patients who developed ventriculoperitoneal shunt infections caused by S. lugdunensis...
  4. Davidyuk G, Soriano S, Goumnerova L, Mizrahi Arnaud A. Acute intraoperative neurogenic pulmonary edema during endoscopic ventriculoperitoneal shunt revision. Anesth Analg. 2010;110:594-5 pubmed publisher
    ..of fulminant intraoperative neurogenic pulmonary edema in a 21-yr-old man undergoing an endoscopic ventriculoperitoneal shunt revision...
  5. Chan M, Alaraj A, Calderon M, Herrera S, Gao W, Ruland S, et al. Prediction of ventriculoperitoneal shunt dependency in patients with aneurysmal subarachnoid hemorrhage. J Neurosurg. 2009;110:44-9 pubmed publisher
    ..An increased FRI score was strongly and linearly correlated with the risk of EVD challenge failure. A prospective study is necessary to validate the FRI. ..
  6. Tubbs R, Acakpo Satchivi L, Blount J, Oakes W, Wellons J. Pericallosal artery pseudoaneurysm secondary to endoscopic-assisted ventriculoperitoneal shunt placement. Case report. J Neurosurg. 2006;105:140-2 pubmed
    ..pseudoaneurysm developed following the endoscopic insertion of a ventricular catheter as part of a ventriculoperitoneal shunt placement procedure. Significant intraventricular bleeding signaled vascular injury...
  7. Loiacono F, Morra A, Venturini S, Balestreri L. Abdominal metastases of medulloblastoma related to a ventriculoperitoneal shunt. AJR Am J Roentgenol. 2006;186:1548-50 pubmed
  8. Srikantha U, Morab J, Sastry S, Abraham R, Balasubramaniam A, Somanna S, et al. Outcome of ventriculoperitoneal shunt placement in Grade IV tubercular meningitis with hydrocephalus: a retrospective analysis in 95 patients. Clinical article. J Neurosurg Pediatr. 2009;4:176-83 pubmed publisher
    ..Ventriculoperitoneal shunts should be considered even in patients who do not improve with an EVD. ..
  9. Prabhakar H, Rath G, Bithal P, Chouhan R. Intracranial pressure and haemodynamic changes during the tunnelling phase of ventriculoperitoneal shunt insertion. Eur J Anaesthesiol. 2005;22:947-50 pubmed
    The tunnelling phase of ventriculoperitoneal shunt insertion is the most painful part but patients are often given inadequate opioid analgesic for fear of post operative delayed recovery and/or respiratory depression...
  10. Barada W, Najjar M, Beydoun A. Early onset tension pneumocephalus following ventriculoperitoneal shunt insertion for normal pressure hydrocephalus: a case report. Clin Neurol Neurosurg. 2009;111:300-2 pubmed publisher
    ..We report a patient who developed an acute subdural tension pneumocephalus within 1 day following placement of a v.p. shunt for normal pressure hydrocephalus as a complication from shunt surgery...
  11. Huang C, Hung Y, Tai S, Lee E. Cerebellar hemorrhage after multiple manual pumping tests of a ventriculoperitoneal shunt: a case report. Kaohsiung J Med Sci. 2009;25:29-33 pubmed publisher
  12. Kanev P, Sheehan J. Reflections on shunt infection. Pediatr Neurosurg. 2003;39:285-90 pubmed
    ..Our infection rate during 62 months was limited to 1.33%. Uniform surgical technique, limited hardware and skin edge manipulation and double gloving may be important factors in limiting shunt infections. ..
  13. Kang J, Lee I. Long-term follow-up of shunting therapy. Childs Nerv Syst. 1999;15:711-7 pubmed
    ..Multicenter and international studies will be easier with the development of a network, and it will give us a strong background to treat hydrocephalus. ..
  14. Sze R, Ghioni V, Weinberger E, Seidel K, Ellenbogen R. Rapid computed tomography technique to measure ventricular volumes in the child with suspected ventriculoperitoneal shunt failure I. Validation of technique with a dynamic phantom. J Comput Assist Tomogr. 2003;27:663-7 pubmed
    ..A new volumetric program accurately measures ventricular volumes and percent change from baseline across a wide range of volumes. ..
  15. Isaacman D, Poirier M, Hegenbarth M, Lillis K, Scarfone R. Ventriculoperitoneal shunt management. Pediatr Emerg Care. 2003;19:119-25 pubmed
  16. McGirt M, Wellons J, Nimjee S, Bulsara K, Fuchs H, George T. Comparison of total versus partial revision of initial ventriculoperitoneal shunt failures. Pediatr Neurosurg. 2003;38:34-40 pubmed
    ..Total revision was not associated with improved shunt survival in patients with IVH. ..
  17. Kajimoto Y, Ohta T, Miyake H, Matsukawa M, Ogawa D, Nagao K, et al. Posture-related changes in the pressure environment of the ventriculoperitoneal shunt system. J Neurosurg. 2000;93:614-7 pubmed
  18. Jackson C, Chwals W, Frim D. A single-incision laparoscopic technique for retrieval and replacement of disconnected ventriculoperitoneal shunt tubing found in the peritoneum. Pediatr Neurosurg. 2002;36:175-7 pubmed
    ..The single-incision technique used here is technically feasible, allows excellent visualization of the peritoneal cavity and does not require any incisions beyond the previous one used for initial shunt insertion. ..
  19. Pathi R, Sage M, Slavotinek J, Hanieh A. Abdominal cerebrospinal fluid pseudocyst. Australas Radiol. 2004;48:61-3 pubmed
    A case of an abdominal cerebrospinal fluid (CSF) pseudocyst in a patient with a ventriculoperitoneal shunt is reported to illustrate this known but rare complication...
  20. Stoodley P, Braxton E, Nistico L, Hall Stoodley L, Johnson S, Quigley M, et al. Direct demonstration of Staphylococcus biofilm in an external ventricular drain in a patient with a history of recurrent ventriculoperitoneal shunt failure. Pediatr Neurosurg. 2010;46:127-32 pubmed publisher
    ..The patient had a history of ventriculoperitoneal shunt revision 3 weeks prior to admission. The shunt was removed on suspicion of infection and an EVD placed...
  21. Savitz M, Bobroff L. Low incidence of delayed intracerebral hemorrhage secondary to ventriculoperitoneal shunt insertion. J Neurosurg. 1999;91:32-4 pubmed
  22. Prusseit J, Simon M, von der Brelie C, Heep A, Molitor E, Volz S, et al. Epidemiology, prevention and management of ventriculoperitoneal shunt infections in children. Pediatr Neurosurg. 2009;45:325-36 pubmed publisher
    ..Considerable personnel and financial resources have been devoted to its diagnosis and treatment. This article reviews the current literature and includes suggestions for the prevention, diagnosis and management of VPS infections. ..
  23. Gil Z, Beni Adani L, Siomin V, Nagar H, Dvir R, Constantini S. Ascites following ventriculoperitoneal shunting in children with chiasmatic-hypothalamic glioma. Childs Nerv Syst. 2001;17:395-8 pubmed
    ..VA shunt may be the treatment of choice for children with chiasmatic or optic nerve gliomas who require a CSF diversion procedure. ..
  24. Washington E, Holmes M, Haines S, Ringwood J. Ventriculoperitoneal shunt migration presenting with vaginal discharge and hydrosalpinx in a 16-year-old patient. Pediatr Emerg Care. 2002;18:28-30 pubmed
  25. Nagai H, Moritake K. Otogenic tension pneumocephalus complicated by eustachian tube insufflation in a patient with a ventriculoperitoneal shunt. Case report. J Neurosurg. 2007;106:1098-101 pubmed
    ..The TPC was controlled successfully by ligation of the shunt tube. The authors discuss the pathophysiology of this complicated TPC case, which illustrates the risk of ET insufflation in patients undergoing CSF shunt surgery...
  26. Kang D, Park J, Park S, Kim Y, Hwang S, Hamm I. Early ventriculoperitoneal shunt placement after severe aneurysmal subarachnoid hemorrhage: role of intraventricular hemorrhage and shunt function. Neurosurgery. 2010;66:904-8; discussion 908-9 pubmed publisher
    ..1% revision rate. There were fewer adverse effects of IVH and protein on shunt performance. Therefore, weaning from an EVD and conversion to a permanent VP shunt need not be delayed because of IVH or proteinaceous CSF. ..
  27. Rotim K, Miklic P, Paladino J, Melada A, Marcikic M, Scap M. Reducing the incidence of infection in pediatric cerebrospinal fluid shunt operations. Childs Nerv Syst. 1997;13:584-7 pubmed
    ..The incidence of shunt infection decreased, with a per patient rate of 8% and a per procedure rate of 5.3%. The majority of infections in our study were caused by Staphylococcus epidermidis, which was found in 22 (52.3%) patients. ..
  28. Reddy G, Bollam P, Caldito G, Willis B, Guthikonda B, Nanda A. Ventriculoperitoneal shunt complications in hydrocephalus patients with intracranial tumors: an analysis of relevant risk factors. J Neurooncol. 2011;103:333-42 pubmed publisher
    ..Patients with intracranial tumors who underwent ventriculoperitoneal shunt placement for hydrocephalus from October 1990 to October 2009 were included in this study...
  29. Acharya R, Bhutani A, Saxena H, Madan V. Complete migration of ventriculoperitoneal shunt into the ventricle. Neurol Sci. 2002;23:75-7 pubmed
    ..One month later, complete migration of the shunt into the lateral ventricle was encountered. Possible causative mechanisms and the literature on this subject are briefly discussed. ..
  30. Omuro A, Lallana E, Bilsky M, DeAngelis L. Ventriculoperitoneal shunt in patients with leptomeningeal metastasis. Neurology. 2005;64:1625-7 pubmed
    The authors reviewed 37 patients with leptomeningeal metastasis (LM) who required a ventriculoperitoneal shunt (VP shunt) for management of intracranial hypertension...
  31. Chitkara N, Gupta R, Singla S, Sharma N. Lower end of ventriculoperitoneal shunt embedding in liver parenchyma. Neurol India. 2004;52:405 pubmed
  32. Rahimi Rad M, Mirzaagazadeh J, Ansarin K. Supradiaphragmatic and transdiaphragmatic intrathoracic migration of a ventriculoperitoneal shunt catheter. Hong Kong Med J. 2007;13:147-9 pubmed
    A hydrothorax following ventriculoperitoneal shunt catheter insertion is very rare and usually reported in children. Only about 25 cases have been described in the literature and very few have been adults...
  33. Schiff D, Kline C, Meltzer H, Auger J. Palliative ventriculoperitoneal shunt in a pediatric patient with recurrent metastatic medulloblastoma. J Palliat Med. 2009;12:391-3 pubmed publisher
    ..Yet for some patients with LM spread and ICH, VP shunting may improve their quality of life, although their prognosis remains poor. ..
  34. Miller J, Fulop S, Dashti S, Robinson S, Cohen A. Rethinking the indications for the ventriculoperitoneal shunt tap. J Neurosurg Pediatr. 2008;1:435-8 pubmed publisher
    Tapping of a suspected malfunctioning ventriculoperitoneal shunt is usually easy, sometimes informative, but also potentially misleading...
  35. Shaw A, Lund J, Semeraro D, Cartmill M, Reynolds J, Tierney G. Large bowel obstruction and perforation secondary to endometriosis complicated by a ventriculoperitoneal shunt. Colorectal Dis. 2008;10:520-1 pubmed publisher
    ..We discuss the rarity of large bowel perforation and obstruction because of endometriosis, and the complications and management of VP shunts. ..
  36. Kestle J, Drake J, Cochrane D, Milner R, Walker M, Abbott R, et al. Lack of benefit of endoscopic ventriculoperitoneal shunt insertion: a multicenter randomized trial. J Neurosurg. 2003;98:284-90 pubmed
    ..The time to first shunt failure was not different between the two groups (log rank = 2.92, p = 0.09). Endoscopic insertion of the initial VP shunt in children suffering from hydrocephalus did not reduce the incidence of shunt failure. ..
  37. Wang Y, Liu Y, Ye X, Chia Y, Liu K. Anesthetic management of laparoscopic surgery in a patient with a ventriculoperitoneal shunt. Acta Anaesthesiol Sin. 2003;41:85-8 pubmed
    ..Therefore, it is not a surprising event that a patient with a ventriculoperitoneal shunt is scheduled for a laparoscopic surgery under anesthesia...
  38. Hofstetter T, Mirzayan M, Krauss J. Ventriculoperitoneal shunt dysfunction in a patient presenting with neurogenic pulmonary edema. Case report. J Neurosurg. 2007;106:701-3 pubmed
    The authors report on a patient with dysfunction of a ventriculoperitoneal shunt who presented with two episodes of neurogenic pulmonary edema within the space of a few months. The edema resolved on correction of the shunt dysfunction...
  39. Mineo J, Phong D, Seizeur R, Mériot P, Besson G. Delayed isolated tension intraventricular pneumocephalus after ventriculoperitoneal shunt. Neurochirurgie. 2004;50:96-100 pubmed
    ..We purpose an explanation for the development of such delayed pneumocephalus...
  40. Kurita N, Shimada M, Nakao T, Chikakiyo M, Miyatani T, Higashijima J, et al. Laparoscopic removal of a foreign body in the pelvic cavity through one port using a flexible cholangioscope. Dig Surg. 2009;26:205-8 pubmed publisher
    ..The patient had a ventriculoperitoneal shunt (V-P shunt) catheter implanted for hydrocephalus of unknown cause in his 40s...
  41. Kumar R, Sahay S, Gaur B, Singh V. Ascites in ventriculoperitoneal shunt. Indian J Pediatr. 2003;70:859-64 pubmed
    ..Four children developing ascites/abdominal psuedocyst following ventriculoperitoneal shunt were analyzed to see the factors responsible for such complication...
  42. Fewel M, Garton H. Migration of distal ventriculoperitoneal shunt catheter into the heart. Case report and review of the literature. J Neurosurg. 2004;100:206-11 pubmed
    Migration of distal ventriculoperitoneal shunt tubing is known to occur in a wide of variety of locations...
  43. Gathura E, Poenaru D, Bransford R, Albright A. Outcomes of ventriculoperitoneal shunt insertion in Sub-Saharan Africa. J Neurosurg Pediatr. 2010;6:329-35 pubmed publisher
    ..Despite limited resources, VP shunt procedures can be carried out in Sub-Saharan Africa with acceptable complication rates and fair long-term outcomes. ..
  44. Forbes J, Reig A, Tomycz L, Tulipan N. Intracranial hypertension caused by a depressed skull fracture resulting in superior sagittal sinus thrombosis in a pediatric patient: treatment with ventriculoperitoneal shunt insertion. J Neurosurg Pediatr. 2010;6:23-8 pubmed publisher
    ..Primary surgical treatment for the symptomatic patient in this setting traditionally involves elevation of the fracture, which often carries significant associated morbidity...
  45. Misaki K, Uchiyama N, Hayashi Y, Hamada J. Intracerebral hemorrhage secondary to ventriculoperitoneal shunt insertion--four case reports. Neurol Med Chir (Tokyo). 2010;50:76-9 pubmed
    ..Bleeding was attributable to venous occlusion due to intraoperative manipulation in Group 1, and to the vulnerability of brain tissue induced by a primary brain disease in Group 2. ..
  46. Fraser J, Fraser C. Gait disorder is the cardinal sign of normal pressure hydrocephalus: a case study. J Neurosci Nurs. 2007;39:132-4, 192 pubmed
    ..A ventriculoperitoneal shunt was then inserted in the patient, and during a 1-year period his symptoms gradually improved...
  47. Yu S, Bensard D, Partrick D, Petty J, Karrer F, Hendrickson R. Laparoscopic guidance or revision of ventriculoperitoneal shunts in children. JSLS. 2006;10:122-5 pubmed
    b>Ventriculoperitoneal shunt is the preferred treatment for hydrocephalus. Known complications include infection, obstruction, and disconnection with the fractured fragment migrating in the peritoneal cavity...
  48. Sarguna P, Lakshmi V. Ventriculoperitoneal shunt infections. Indian J Med Microbiol. 2006;24:52-4 pubmed
    ..The antibiotic sensitivity pattern suggests cephalosporins and quinolones to be a better choice of antibiotics either prophylactically or therapeutically, which may result in effective and rapid sterilisation of the CSF. ..
  49. Felipe Murcia M, Almagro M, Martínez Lage J. Retrograde migration of ventriculoperitoneal shunt to the neck. Case report. Neurocirugia (Astur). 2006;17:450-2 pubmed
    We report a patient, given a ventriculoperitoneal shunt at the neonatal period, who presented with a painless subcutaneous mass on his neck...
  50. Esposito C, Colella G, Settimi A, Centonze A, Signorelli F, Ascione G, et al. One-trocar laparoscopy: a valid procedure to treat abdominal complications in children with peritoneal shunt for hydrocephalus. Surg Endosc. 2003;17:828-30 pubmed
    ..One-trocar laparoscopic surgery can be considered as the ideal procedure in case of abdominal complications of VPS in children with hydrocephalus. ..
  51. Acharya R, Ramachandran C, Singh S. Laparoscopic management of abdominal complications in ventriculoperitoneal shunt surgery. J Laparoendosc Adv Surg Tech A. 2001;11:167-70 pubmed
    ..Thus, a conventional laparotomy, along with its various associated postoperative problems, was avoided without compromising the quality of surgery. ..
  52. Brunori A, Massari A, Macarone Palmieri R, Benini B, Chiappetta F. Minimally invasive treatment of giant CSF pseudocyst complicating ventriculoperitoneal shunt. Minim Invasive Neurosurg. 1998;41:38-9 pubmed
    A two-liter cerebrospinal fluid pseudocyst complicating a ventriculoperitoneal shunt was drained and a distal catheter retrieved from the peritoneal cavity by laparoscopy...
  53. Riffaud L, Ferre J, Carsin Nicol B, Morandi X. Endoscopic third ventriculostomy for the treatment of obstructive hydrocephalus during pregnancy. Obstet Gynecol. 2006;108:801-4 pubmed
    ..for newly diagnosed acute obstructive hydrocephalus (n=2) or in cases of malfunction of a preexisting ventriculoperitoneal shunt (n=3) are presented...