Huge abdominal cerebrospinal fluid pseudocyst following ventriculoperitoneal shunt: a case report

Journal of Medical Case Reports

Takaaki Osako¹  Tetsuya Yumoto¹  Toshiyuki Aokage¹  Noritomo Fujisaki¹  Atsunori Nakao¹  Hiromi Ihoriya¹  Yasuhiro Koide¹  Hiromichi Naito¹  Hirotsugu Yamamoto¹  Isao Date²  Masahiro Kameda² 

[1] Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences;Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences;

关键词: Abdominal pseudocyst;    Cerebrospinal fluid;    Complication;    Ventriculoperitoneal shunt;   

DOI  :  10.1186/s13256-019-2308-0

来源: DOAJ

【 摘 要 】

Abstract Introduction Abdominal pseudocysts comprising cerebrospinal fluid are an uncommon but significant complication in patients with ventriculoperitoneal shunt. We present a successfully treated 12-year-old boy with a history of ventriculoperitoneal shunting and a huge abdominal cerebrospinal fluid pseudocyst. Case presentation A12-year-old Japanese boy presented with a deteriorated consciousness and a palpable and elastic large lower abdominal mass. Computed tomography of his abdomen demonstrated a collection of homogenous low-density fluid near the catheter tip of the ventriculoperitoneal shunt. Cerebral computed tomography revealed an increased ventricular size. Based on the clinical diagnosis of abdominal pseudocyst, the peritoneal shunt catheter was secured and divided into two parts by cutting it on the chest; then, the proximal side of the peritoneal shunt catheter was externalized for extraventricular drainage. The cyst was percutaneously aspirated with ultrasound guidance, and the distal side of the peritoneal shunt catheter was removed. The distal side of the peritoneal shunt catheter was reinserted in another position into his abdomen after 3-week extraventricular drainage management. Conclusion Emergency physicians should know about this potential complication as an important differential diagnosis resulting from acute abdominal complaints in patients with ventriculoperitoneal shunts.

【 授权许可】

Unknown