Transdiaphragmatic ventriculoperitoneal shunting: technical case report.

OBJECTIVE AND IMPORTANCE

This report describes an important technical modification in ventriculoperitoneal shunting.

CLINICAL PRESENTATION

A young woman presented with shunt malfunction caused by occlusion of the peritoneal catheter. Conventional sites for placement of distal catheter were unavailable or had been used up.

INTERVENTION

After the installation of a ventriculopleural shunt resulted in pleural effusion, it was converted to a transdiaphragmatic ventriculoperitoneal shunt, resulting in an excellent clinical outcome.

CONCLUSION

The suprahepatic subdiaphragmatic space can be directly accessed in some selected patients with extensive peritoneal adhesions, resulting in successful ventriculoperitoneal shunting.