Ventriculoperitoneal shunt occlusion secondary to strangulated ventral hernia: A case report

Ventriculoperitoneal (VP) shunting is the gold-standard treatment for hydrocephalus; however, it can lead to numerous complications. VP shunt malfunction from occlusion secondary to a ventral wall hernia is rare and poorly described. Herein, we present the case of a VP shunt occlusion complicated by a strangulated ventral wall hernia. A 39-year-old male with a past medical history of hydrocephalus and multiple previous abdominal surgeries presented with headache, abdominal pain, and erythema along with a non-reducible ventral hernia. Computed tomography (CT) scan of the head demonstrated interval ventriculomegaly when compared to prior imaging of the head. CT abdominal scan revealed a strangulated ventral hernia containing omental fat as well as a section of the peritoneal portion of the patient’s VP shunt. The patient would ultimately undergo peritoneal catheter re-positioning and ventral hernia repair without mesh placement. Despite utilizing an open technique to repair the patient’s hernia, the VP shunt was successfully re-positioned, and the feared complication of a shunt infection was nullified.