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The diversion of cerebrospinal fluid CSF for hydrocephalus is an established surgical practice, after its feasibility was demonstrated in the early s [ 1 ]. Various valve assemblies have been devised and we use valve regulated ventriculoperitoneal shunt with a slit lower end [ 2 ]. Many abdominal complications have been described which include fibrous encasement of the peritoneal tip, blocking or kinking of the distal tube, slipping out through the surgical wound or migration of the shunt or its component parts into the various abdominal cavities [ 2 ]. Other complications are infection, CSF fistula, paralytic ileus in the immediate postoperative period, failure of peritoneal absorption of the diverted CSF, perforation of the bowel by the abdominal tube, development of hydrocele, appearance of a peritoneal cyst and spontaneous extrusion of the tube through the umbilicus [ 3 , 4 ]. We highlight an unusual complication of this procedure with two of our cases developing spontaneous extrusion of the lower end of the tube through the anal opening.
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