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.