Background: Ventriculoperitoneal shunt (VP shunt) surgery is one of the most common procedures being performed in the pediatric age group in neurosurgical centers worldwide. Although considered a simple surgery, the complications have made it one of the most difficult procedures to manage in the long term. In this study, we describe our experiences in managing the unusual complications of this common procedure in children. Materials and Methods: This retrospective study enrolled 13 pediatric cases having unusual complications related to VP shunt who presented to us from August 2013 to August 2019. All the cases were evaluated for their demographic profile, type of complications, possible pathophysiology, outcome, and management. We had used only spring-valve-based Chhabra VP shunt in all of our cases. Results: The age group ranged between 2 and 18 years, with a male to female ratio of 9:4. Anal extrusion of distal shunt tube was observed in four cases, and two cases each of urethral and oral extrusion were also seen. Two cases developed extrusion of shunt tube through the anterior abdominal wall and one case developed umbilical fistula. Multiple extradural hematoma and intraventricular bleed with partial shunt coil were also seen in each of the cases, respectively. All cases were managed as per need. Conclusion: Unusual complications of VP shunt surgery are increasingly being observed nowadays. Prompt diagnosis and treatment of these complications result in an excellent outcome.
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