We present the clinical case of a 17-year-old male who developed an ascitic syndrome 11 years after the establishment of a ventricular-peritoneal shunt as the consequence of a malformation hydrocephalus. We discuss the pathogenic mechanism and present histopathological evidence that justifies the accumulation of spinal fluid in the peritoneal cavity. We insist on the convenience of keeping in mind this clinical situation in order to avoid unnecessary complementary exams and we analyze the most adequate therapeutic schedule.