Cerebrospinal fluid (CSF) ascites is a rare complication of ventriculoperitoneal (PV) shunt. The
etiological factors and especially the mechanisms underlying this complication remain difficult to
explain. We report the case of a voluminous CSF ascites complicating a PV shunt, 15 years later. This
is a 16-year-old patient, valved at the age of one year, admitted for major abdominal distension. The
abdominal scanner shows a large free fluid collection in the peritoneal cavity. The puncture of this ascites
and above all the conversion of the PV shunt into a ventriculo-atrial bypass allowed the collection to
dry up. The various hypotheses mentioned in the literature struggle to explain the occurrence of ascites
in this patient. This ascites seems to stem from a progressive failure of the mechanisms of peritoneal
resorption over time and this apart from any primary peritoneal pathology
