A small number of patients with congenital hydrocephalus, who have been treated effectively with ventriculoperitoneal shunts, develop progressive increase in abdominal girth, due to cerebrospinal fluid ascites. This abdominal distension can produce respiratory difficulties that require endotracheal intubation and ventilator support. The respiratory difficulties and the abdominal distension were eliminated when the ventriculoperitoneal shunt was converted to a ventriculoatrial shunt in each of the three cases presented in this paper for discussion.
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