title: Transdiaphragmatic ventriculoperitoneal shunting: technical case report.
abstract: OBJECTIVE
  This report describes an important technical modification in ventriculoperitoneal shunting.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  The suprahepatic subdiaphragmatic space can be directly accessed in some selected patients with extensive peritoneal adhesions, resulting in successful ventriculoperitoneal shunting.
authors.affiliation: Department of Neurosurgery, University of Minnesota Hospital, Minneapolis, USA.
authors.forename: S S
authors.initials: SS
authors.lastname: Rengachary
mesh_terms: D000328:Adult; D001139:Arnold-Chiari Malformation / Q000000981:diagnostic imaging / Q000601:surgery*; D003964:Diaphragm / Q000601:surgery; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000601:surgery*; D008591:Meningomyelocele / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012008:Recurrence; D012086:Reoperation; D017287:Ventriculoperitoneal Shunt / Q000295:instrumentation*