• Qi Yu, Chengjian Lou, Tianda Feng, and Yunhui Liu.
• Department of Neurosurgery, Shengjing Hospital of China Medical University.
• Medicine (Baltimore). 2020 Jun 19; 99 (25): e20565.

RationaleVentriculoperitoneal 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 ConcernsA 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.DiagnosesChronic 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.InterventionsLaparoscopic cholecystectomy was performed successfully, requiring no further shunt manipulation.OutcomesThe 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.ConclusionTo 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.

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