Replacement of a 35-year-old Ventriculo-peritoneal Shunt by Endoscopic Third Ventriculostomy during Abdominal Surgery: A Case Report

Abstract

A 47-year-old woman, who underwent a ventriculo-peritoneal shunt for obstructive hydrocephalus due to a pineal tumor 35years ago, was scheduled to have abdominal surgery for colon cancer. For the peri-operative period, the peritoneal shunt tube was removed and ventricular drainage was performed to control the intracranial pressure using a ventricular shunt tube. After a definitive diagnosis of aqueductal stenosis by drainage test occlusion and MRI, an endoscopic third ventriculostomy was performed. The risk of shunt infection and malfunction due to the abdominal surgery was avoided, and also the damaged, but still functioning, 35-year-old shunt system was removed without shunt revision.