Ventriculoperitoneal shunt malfunction due to chronic cholecystitis: A case report

RATIONALE: Ventriculoperitoneal shunt (VPS) is the most common treatment for idiopathic normal pressure hydrocephalus, a subtype of hydrocephalus characterized by gait disturbance, dementia, and urinary incontinence. However, while the malfunction of VPS is reported at a high rate, the involvement of chronic cholecystitis in shunt malfunction is rare. PATIENT CONCERNS: A 73-year-old woman with idiopathic normal pressure hydrocephalus who received a VPS but subsequently developed chronic cholecystitis. The patient suffered from drowsiness and was unable to walk. Her family found that she presented with poor appetite and was bloated. DIAGNOSES: Chronic cholecystitis was confirmed through abdominal computed tomography, which showed a swollen, and enlarged gallbladder, and flatulence. A head computed tomography scan indicated hydrocephalus with enlarged ventricular system and paraventricular edema. INTERVENTIONS: Laparoscopic cholecystectomy was performed successfully, requiring no further shunt manipulation. OUTCOMES: The patient's memory and cognitive ability were slightly impaired without a positive sign in the abdomen. No catheter or abdominal infection signs were observed during the following 3 months of follow-up. CONCLUSION: To the best of our knowledge, this report is the first to reveal that shunt malfunction may result from chronic cholecystitis, which induced the presently observed intra-abdominal hypertension.