Hydrocephalus is a prevalent health problem that is frequently encountered by paediatric neurosurgeons during infancy and childhood. We report a case of an 11-year-old boy with high cerebrospinal fluid protein hydrocephalus secondary to optic glioma that required a ventriculoperitoneal (VP) shunt. The patient had multiple failures of VP shunt and developed massive ascites. Alternatively, the hydrocephalus was treated by ventriculo-gallbladder (VG) shunt in the presence of sludge which was removed from the gallbladder before placement of the shunt. After VG shunt insertion, the patient expressed signs of infection with elevated liver profile, which emphasised the presence of gallstones. While the shunt was kept in its place without any complications, the gallstones were successfully removed by an endoscopic retrograde cholangiopancreatography. In conclusion, the presence of sludge is not a contraindication for VG shunt placement, and, if the VG shunt was complicated with gallstones, it could be treated without the need for cholecystectomy.

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Management of a traumatic ruptured aorta in the pediatric population is quite challenging. Options vary, with each having its own morbidity, and include open repair, endovascular stent grafts, and/or anti-impulse therapy. Although endovascular stenting is an emerging management modality in traumatic aortic injury in adults, open repair is still the gold standard in the pediatric population.In this case, we reported the survival of a three-year-old boy who underwent successful surgical repair with a Dacron graft and anastomosis after an acute traumatic thoracic aortic pseudoaneurysm with mediastinal hematoma.

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