Introduction: Ventriculo-gallbladder shunt (VGS) has been recognized as a last-resort alternative to treat hydrocephalus when the peritoneum and/or other distal sites can no longer receive shunts. In some specific conditions, it may be conceded as a first-line treatment. Case presentation: We report the case of a 6- month-old girl with progressive post-hemorrhagic hydrocephalus and who presented a concomitant chronic abdominal symptom. Specific investigations ruled out acute infection and led to the diagnosis of chronic appendicitis. Both problems were managed in a one-stage salvage procedure consisting of laparotomy sanctioning to treat the abdominal pathology and seize the opportunity to perform a VGS as a first option since the abdomen is prone to ventriculoperitoneal shunt (VPS) failure. Conclusion: Only few cases have reported the use of VGS as the first option to handle uncommon complex cases due to abdominal or Cerebro-Spinal Fluid (CSF) conditions. We wish to draw attention to VGS as an effective procedure not only in children with multiple shunt failures but also as first-line management in some selected cases.

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Ventriculo-gallbladder shunt (VGS) has been recognized as a last-resort alternative to treat hydrocephalus when the peritoneum and/or other distal sites can no longer receive shunts. In some speci c conditions, it may be conceded as a rst-line treatment. Case presentation:We report the case of a 6-month-old girl with progressive post-hemorrhagic hydrocephalus and who presented a concomitant chronic abdominal symptom. Speci c investigations ruled out acute infection and led to the diagnosis of chronic appendicitis. Both problems were managed in a one-stage salvage procedure consisting of laparotomy sanctioning to treat the abdominal pathology and seize the opportunity to perform a VGS as a rst option since the abdomen is prone to ventriculoperitoneal shunt (VPS) failure. Conclusion:Only few cases have reported the use of VGS as the rst option to handle uncommon complex cases due to abdominal or Cerebro-Spinal Fluid (CSF) conditions. We wish to draw attention to VGS as an effective procedure not only in children with multiple shunt failures but also as rst-line management in some selected cases.

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