{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T11:13:20Z","timestamp":1770462800135,"version":"3.49.0"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"17","license":[{"start":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T00:00:00Z","timestamp":1635120000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,25]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>When ventriculoperitoneal (VP) shunts and umbilical hernias coexist in the same patient, unique complications can occur. Typically, these are readily identified problems such as cerebrospinal fluid (CSF) fistulas or entrapment of the peritoneal catheter in the hernia. The authors present cases of two children whose VP shunt dysfunction resolved after repair of their umbilical hernias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors present two cases of infant patients with shunted hydrocephalus and umbilical hernias. In both cases, the patients presented with distal shunt malfunctions not due to infection. Their shunt function improved once the umbilical hernia was repaired by pediatric surgery. Neither has required shunt revision since umbilical hernia repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Although there are case reports of VP shunts eroding through the umbilicus, developing CSF fistulas, or becoming trapped inside umbilical hernias, there is no case of VP shunt dysfunction caused by just the presence of an umbilical hernia. The authors suspect that the catheter may intermittently enter and exit the hernia. This may cause intermittent obstruction of the distal catheter, or inflammation in the hernia may occur that limits CSF absorption.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case21455","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T03:04:37Z","timestamp":1635735877000},"source":"Crossref","is-referenced-by-count":1,"title":["Umbilical hernia causing ventriculoperitoneal shunt dysfunction: illustrative cases"],"prefix":"10.3171","volume":"2","author":[{"given":"Lacey M.","family":"Carter","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Ruiz-Elizalde","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naina L.","family":"Gross","sequence":"additional","affiliation":[{"name":"Warren Clinic Pediatric Neurosurgery, Saint Francis Health System, Tulsa, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"J Pediatr Surg","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1016\/0022-3468(75)90104-9","article-title":"The management of umbilical hernias in infancy and childhood","volume":"10","author":"Lassaletta L","year":"1975","unstructured":"Lassaletta L, Fonkalsrud EW, Tovar JA, Dudgeon D, Asch MJ. The management of umbilical hernias in infancy and childhood. J Pediatr Surg. 1975;10(3):405\u2013409.10.1016\/0022-3468(75)90104-9"},{"issue":"4","key":"b2","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"481","DOI":"10.3171\/jns.1975.43.4.0481","article-title":"Spontaneous umbilical fistula from ventriculoperitoneal shunt drainage. Report of two cases","volume":"43","author":"Antunes AC","year":"1975","unstructured":"Antunes AC, Ribeiro TR. Spontaneous umbilical fistula from ventriculoperitoneal shunt drainage. Report of two cases. J Neurosurg. 1975;43(4):481\u2013482.10.3171\/jns.1975.43.4.0481515904"},{"issue":"1","key":"b3","series-title":"Iran J Pediatr","first-page":"127","article-title":"Umbilical hernia and ventriculoperitoneal shunt complications","volume":"21","author":"Ardalan M","year":"2011","unstructured":"Ardalan M, Rafati AH, Nejat F, El Khashab M. Umbilical hernia and ventriculoperitoneal shunt complications. Iran J Pediatr. 2011;21(1):127\u2013128.12053172"},{"issue":"4","key":"b4","series-title":"J Pediatr Surg","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1016\/0022-3468(93)90676-C","article-title":"Spontaneous umbilical fistula: a rare complication of ventriculoperitoneal shunt","volume":"28","author":"Das PC","year":"1993","unstructured":"Das PC, Radhakrishna K, Rao PL. Spontaneous umbilical fistula: a rare complication of ventriculoperitoneal shunt. J Pediatr Surg. 1993;28(4):630\u2013631.10.1016\/0022-3468(93)90676-C"},{"key":"b5","series-title":"Int J Surg Case Rep","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.ijscr.2015.12.052","article-title":"Cerebrospinal fluid leakage from the umbilicus: case report and literature review","volume":"20","author":"Dolas I","year":"2016","unstructured":"Dolas I, Apaydin HO, Yucetas SC, Ucar MD, Kilinc S, Ucler N. Cerebrospinal fluid leakage from the umbilicus: case report and literature review. Int J Surg Case Rep. 2016;20:60\u201362.10.1016\/j.ijscr.2015.12.052515904"},{"issue":"11","key":"b6","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1007\/s00701-006-0898-y","article-title":"Umbilical CSF fistula: a rare complication of ventriculoperitoneal shunt","volume":"148","author":"Gupta A","year":"2006","unstructured":"Gupta A, Ahmad FU, Kumar A, Gaikwad S, Vaishya S. Umbilical CSF fistula: a rare complication of ventriculoperitoneal shunt. Acta Neurochir (Wien). 2006;148(11):1205\u20131207.10.1007\/s00701-006-0898-y12053172"},{"issue":"5","key":"b7","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1159\/000106389","article-title":"CSF fistula through the umbilicus following a shunt surgery: a case report and literature review","volume":"43","author":"Mohindra S","year":"2007","unstructured":"Mohindra S, Singla N, Gupta R, Gupta SK. CSF fistula through the umbilicus following a shunt surgery: a case report and literature review. Pediatr Neurosurg. 2007;43(5):396\u2013398.10.1159\/000106389"},{"issue":"2","key":"b8","series-title":"Surg Neurol","first-page":"129","article-title":"Umbilical fistula as a complication of ventriculo-peritoneal shunt","volume":"12","author":"Pompili A","year":"1979","unstructured":"Pompili A, Cianfriglia F. Umbilical fistula as a complication of ventriculo-peritoneal shunt. Surg Neurol. 1979;12(2):129\u2013130."},{"issue":"2\u20133 Pt 1","key":"b9","series-title":"Neurochirurgie","first-page":"128","article-title":"The spontaneous umbilical perforation of the distal end of ventriculoperitoneal shunt","volume":"48","author":"Silav G","year":"2002","unstructured":"Silav G, Tun K, Dolgun H, Unlu A, Selcuki M. The spontaneous umbilical perforation of the distal end of ventriculoperitoneal shunt. Neurochirurgie. 2002;48(2\u20133 Pt 1):128\u2013130."},{"issue":"2\u20133","key":"b10","series-title":"Pediatr Surg Int","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1007\/s003830100608","article-title":"Protrusion of a peritoneal catheter through the umblicus: an unusual complication of a ventriculoperitoneal shunt","volume":"18","author":"Wani AA","year":"2002","unstructured":"Wani AA, Ramzan A, Wani MA. Protrusion of a peritoneal catheter through the umblicus: an unusual complication of a ventriculoperitoneal shunt. Pediatr Surg Int. 2002;18(2\u20133):171\u2013172.10.1007\/s003830100608"},{"issue":"3","key":"b11","series-title":"J Pediatr Surg","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/S0022-3468(98)90080-X","article-title":"Ventriculo-peritoneal shunts in children reveal the natural history of closure of the processus vaginalis","volume":"33","author":"Clarnette TD","year":"1998","unstructured":"Clarnette TD, Lam SK, Hutson JM. Ventriculo-peritoneal shunts in children reveal the natural history of closure of the processus vaginalis. J Pediatr Surg. 1998;33(3):413\u2013416.10.1016\/S0022-3468(98)90080-X"},{"issue":"5","key":"b12","series-title":"Curr Probl Diagn Radiol","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1067\/j.cpradiol.2017.07.006","article-title":"Common and uncommon causes of ventriculoperitoneal shunt malfunction diagnosed on plain radiographs","volume":"47","author":"Bates P","year":"2018","unstructured":"Bates P, Rajderkar D. Common and uncommon causes of ventriculoperitoneal shunt malfunction diagnosed on plain radiographs. Curr Probl Diagn Radiol. 2018;47(5):317\u2013323.10.1067\/j.cpradiol.2017.07.006"},{"issue":"6","key":"b13","series-title":"J Surg Case Rep","doi-asserted-by":"publisher","first-page":"rju059","DOI":"10.1093\/jscr\/rju059","article-title":"Repeated cannulation of umbilical hernia with Ventriculoperiotoneal shunt catheter","volume":"2014","author":"Laidlaw RS","year":"2014","unstructured":"Laidlaw RS, Little N. Repeated cannulation of umbilical hernia with Ventriculoperiotoneal shunt catheter. J Surg Case Rep. 2014;2014(6):rju059.10.1093\/jscr\/rju059"},{"issue":"9","key":"b14","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1007\/s00381-006-0054-2","article-title":"Sterile ascites from a ventriculoperitoneal shunt: a case report and review of the literature","volume":"22","author":"Diluna ML","year":"2006","unstructured":"Diluna ML, Johnson MH, Bi WL, Chiang VL, Duncan CC. Sterile ascites from a ventriculoperitoneal shunt: a case report and review of the literature. Childs Nerv Syst. 2006;22(9):1187\u20131193.10.1007\/s00381-006-0054-2"},{"issue":"3","key":"b1","series-title":"J Pediatr Surg","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1016\/0022-3468(75)90104-9","article-title":"The management of umbilical hernias in infancy and childhood","volume":"10","author":"Lassaletta L","year":"1975","unstructured":"Lassaletta L, Fonkalsrud EW, Tovar JA, Dudgeon D, Asch MJ. The management of umbilical hernias in infancy and childhood. J Pediatr Surg. 1975;10(3):405\u2013409.10.1016\/0022-3468(75)90104-9"},{"issue":"4","key":"b2","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"481","DOI":"10.3171\/jns.1975.43.4.0481","article-title":"Spontaneous umbilical fistula from ventriculoperitoneal shunt drainage. Report of two cases","volume":"43","author":"Antunes AC","year":"1975","unstructured":"Antunes AC, Ribeiro TR. Spontaneous umbilical fistula from ventriculoperitoneal shunt drainage. Report of two cases. J Neurosurg. 1975;43(4):481\u2013482.10.3171\/jns.1975.43.4.0481"},{"issue":"1","key":"b3","series-title":"Iran J Pediatr","first-page":"127","article-title":"Umbilical hernia and ventriculoperitoneal shunt complications","volume":"21","author":"Ardalan M","year":"2011","unstructured":"Ardalan M, Rafati AH, Nejat F, El Khashab M. Umbilical hernia and ventriculoperitoneal shunt complications. Iran J Pediatr. 2011;21(1):127\u2013128."},{"issue":"4","key":"b4","series-title":"J Pediatr Surg","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1016\/0022-3468(93)90676-C","article-title":"Spontaneous umbilical fistula: a rare complication of ventriculoperitoneal shunt","volume":"28","author":"Das PC","year":"1993","unstructured":"Das PC, Radhakrishna K, Rao PL. Spontaneous umbilical fistula: a rare complication of ventriculoperitoneal shunt. J Pediatr Surg. 1993;28(4):630\u2013631.10.1016\/0022-3468(93)90676-C"},{"key":"b5","series-title":"Int J Surg Case Rep","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.ijscr.2015.12.052","article-title":"Cerebrospinal fluid leakage from the umbilicus: case report and literature review","volume":"20","author":"Dolas I","year":"2016","unstructured":"Dolas I, Apaydin HO, Yucetas SC, Ucar MD, Kilinc S, Ucler N. Cerebrospinal fluid leakage from the umbilicus: case report and literature review. Int J Surg Case Rep. 2016;20:60\u201362.10.1016\/j.ijscr.2015.12.052"},{"issue":"11","key":"b6","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1007\/s00701-006-0898-y","article-title":"Umbilical CSF fistula: a rare complication of ventriculoperitoneal shunt","volume":"148","author":"Gupta A","year":"2006","unstructured":"Gupta A, Ahmad FU, Kumar A, Gaikwad S, Vaishya S. Umbilical CSF fistula: a rare complication of ventriculoperitoneal shunt. Acta Neurochir (Wien). 2006;148(11):1205\u20131207.10.1007\/s00701-006-0898-y"},{"issue":"5","key":"b7","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1159\/000106389","article-title":"CSF fistula through the umbilicus following a shunt surgery: a case report and literature review","volume":"43","author":"Mohindra S","year":"2007","unstructured":"Mohindra S, Singla N, Gupta R, Gupta SK. CSF fistula through the umbilicus following a shunt surgery: a case report and literature review. Pediatr Neurosurg. 2007;43(5):396\u2013398.10.1159\/000106389"},{"issue":"2","key":"b8","series-title":"Surg Neurol","first-page":"129","article-title":"Umbilical fistula as a complication of ventriculo-peritoneal shunt","volume":"12","author":"Pompili A","year":"1979","unstructured":"Pompili A, Cianfriglia F. Umbilical fistula as a complication of ventriculo-peritoneal shunt. Surg Neurol. 1979;12(2):129\u2013130."},{"issue":"2\u20133 Pt 1","key":"b9","series-title":"Neurochirurgie","first-page":"128","article-title":"The spontaneous umbilical perforation of the distal end of ventriculoperitoneal shunt","volume":"48","author":"Silav G","year":"2002","unstructured":"Silav G, Tun K, Dolgun H, Unlu A, Selcuki M. The spontaneous umbilical perforation of the distal end of ventriculoperitoneal shunt. Neurochirurgie. 2002;48(2\u20133 Pt 1):128\u2013130."},{"issue":"2\u20133","key":"b10","series-title":"Pediatr Surg Int","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1007\/s003830100608","article-title":"Protrusion of a peritoneal catheter through the umblicus: an unusual complication of a ventriculoperitoneal shunt","volume":"18","author":"Wani AA","year":"2002","unstructured":"Wani AA, Ramzan A, Wani MA. Protrusion of a peritoneal catheter through the umblicus: an unusual complication of a ventriculoperitoneal shunt. Pediatr Surg Int. 2002;18(2\u20133):171\u2013172.10.1007\/s003830100608"},{"issue":"3","key":"b11","series-title":"J Pediatr Surg","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/S0022-3468(98)90080-X","article-title":"Ventriculo-peritoneal shunts in children reveal the natural history of closure of the processus vaginalis","volume":"33","author":"Clarnette TD","year":"1998","unstructured":"Clarnette TD, Lam SK, Hutson JM. Ventriculo-peritoneal shunts in children reveal the natural history of closure of the processus vaginalis. J Pediatr Surg. 1998;33(3):413\u2013416.10.1016\/S0022-3468(98)90080-X"},{"issue":"5","key":"b12","series-title":"Curr Probl Diagn Radiol","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1067\/j.cpradiol.2017.07.006","article-title":"Common and uncommon causes of ventriculoperitoneal shunt malfunction diagnosed on plain radiographs","volume":"47","author":"Bates P","year":"2018","unstructured":"Bates P, Rajderkar D. Common and uncommon causes of ventriculoperitoneal shunt malfunction diagnosed on plain radiographs. Curr Probl Diagn Radiol. 2018;47(5):317\u2013323.10.1067\/j.cpradiol.2017.07.006"},{"issue":"6","key":"b13","series-title":"J Surg Case Rep","doi-asserted-by":"publisher","first-page":"rju059","DOI":"10.1093\/jscr\/rju059","article-title":"Repeated cannulation of umbilical hernia with Ventriculoperiotoneal shunt catheter","volume":"2014","author":"Laidlaw RS","year":"2014","unstructured":"Laidlaw RS, Little N. Repeated cannulation of umbilical hernia with Ventriculoperiotoneal shunt catheter. J Surg Case Rep. 2014;2014(6):rju059.10.1093\/jscr\/rju059"},{"issue":"9","key":"b14","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1007\/s00381-006-0054-2","article-title":"Sterile ascites from a ventriculoperitoneal shunt: a case report and review of the literature","volume":"22","author":"Diluna ML","year":"2006","unstructured":"Diluna ML, Johnson MH, Bi WL, Chiang VL, Duncan CC. Sterile ascites from a ventriculoperitoneal shunt: a case report and review of the literature. Childs Nerv Syst. 2006;22(9):1187\u20131193.10.1007\/s00381-006-0054-2"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/2\/17\/article-CASE21455.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/2\/17\/article-CASE21455.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/2\/17\/article-CASE21455.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T14:55:37Z","timestamp":1770303337000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/2\/17\/article-CASE21455.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,25]]},"references-count":28,"journal-issue":{"issue":"17"},"URL":"https:\/\/doi.org\/10.3171\/case21455","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,25]]}}}