Orbital emphysema post laparoscopic Nissen fundoplication in an adult with ventriculoperitoneal shunt. Case report.

Introduction: Currently there is controversy with regard to safety of laparoscopic surgery performed in patients with a ventriculoperitoneal shunt (VPS). An increased intra-abdominal pressure and eventually impaired shunt function may possibly increase intracranial pressure. Although no report of pneumocephalus due to retrograde valve failure has been published, other complications may not be neglected.