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Background: The estimated prevalence of hydrocephalus in all age groups is between 1-1.5%. Placement of a ventriculoperitoneal (VP) shunt in such patients offers them relatively normal lives. There is minimal data concerning the risk of postoperative complications in shunted patients undergoing subsequent major visceral operations. We hypothesized that healthy adults who had VP shunts placed for acquired conditions and later underwent gastric or colon cancer surgery would frequently have dense shunt-related adhesions and high rates of adverse outcomes. Methods: We assumed that all veterans were healthy on entry into military service. We searched national VA databases from 1994-2003 to identify all VA patients with shunts for acquired conditions and a curative-intent operation for stomach or colon cancer. We conducted a chart review to determine their clinical courses. Results: Five patients had codes for VP shunt, gastric cancer, and gastrectomy; 3 met our inclusion criteria. Fourteen had codes for VP shunt, colon cancer, and colectomy; 4 met our criteria. One of the evaluable gastrectomy patients had dense shunt-related adhesions. There were no post-operative complications in any of the 7 patients. VP shunts were managed by administering prophylactic antibiotics preoperatively and isolating the shunt with surgical sponges intra-operatively. Conclusions: We believe this is the first report analyzing the clinical course of adults with VP shunts who later have major abdominal cancer surgery. The presence of a shunt was associated with dense adhesions in one of the 7 patients in this series (14%) but not with increased risk of post-operative complications.